Concierge Spine and Sports Medicine, PC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

CONCIERGE SPINE AND SPORTS MEDICINE, PC

Practice address

1200 Constitution Ave
Philadelphia, PA 19112-1329

Phone

(267) 551-4200

Fax

(856) 861-0928

NPI assigned

May 18, 2022

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Malini M Khanna, MDNPI 1306087200

Title

Physician Owner

Phone

(267) 551-4200

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Malini M Khanna, M.D.

  • Interventional Pain Medicine Physician
  • Sewell, NJ
  • NPI 1306087200

  PA

  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1652832000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684281600000",
    "number": "1831836162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 MADEIRA CT",
            "city": "MOORESTOWN",
            "state": "NJ",
            "postal_code": "080573144",
            "telephone_number": "202-262-5629",
            "fax_number": "856-861-0928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 CONSTITUTION AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191121329",
            "telephone_number": "267-551-4200",
            "fax_number": "856-861-0928"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Marter Ave Ste 700",
            "address_purpose": "LOCATION",
            "city": "Moorestown",
            "state": "NJ",
            "postal_code": "080573147",
            "country_code": "US",
            "telephone_number": "267-551-4200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CONCIERGE SPINE AND SPORTS MEDICINE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-18",
        "last_updated": "2023-05-17",
        "certification_date": "2023-05-17",
        "status": "A",
        "authorized_official_last_name": "KHANNA",
        "authorized_official_first_name": "MALINI",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PHYSICIAN OWNER",
        "authorized_official_telephone_number": "267-551-4200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maria Victoria Concepcion Delgado
• Kristine J Concepcion, D.M.D.
• Sheila Concepcion, O.D.
• Concern Home Care
• Concierge Physical Therapy, LLC
• Concorde, Inc.
• Concordia Center of Clinical Chiropractic &Rehabilitation LLC
• Matenne Conde
• Sade Condell
• Courtney Condit

• Clinic/Center in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Clinic/Center in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.