NPIMap

Organization Active NPI

Suburban Primary Care

  • Family Medicine Physician
  • Newtown Square, PA
National Provider Identifier
1841364510
Registry record updated May 27, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
SUBURBAN PRIMARY CARE
Practice address
3475 W Chester Pike
Suite 200
Newtown Square, PA 19073-4280
Phone
(610) 356-0300
Fax
(610) 356-1981
NPI assigned
Nov 17, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 27, 2008

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

Authorized official

Name
Ms. Katie McCormick
Title
Credentialer
Phone
(610) 356-0300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

3475 W Chester Pike
Suite 200
Newtown Square, PA 19073-4280

Mailing address

3475 W Chester Pike
Suite 200
Newtown Square, PA 19073-4280
Phone (610) 356-0300

Other identifiers 2

IdentifierTypeStateIssuer
085555OtherPAAETNA ID
0142949001OtherPAKEYSTONE ID

National Provider Directory

National Provider Directory

Locations

3475 West Chester Pike
Ste 200
Newtown Square, PA 19073
Phone (610) 356-0300

Practitioners & affiliated clinicians

Practitioners 6

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

NPI Registry JSON

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

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211846400000",
    "number": "1841364510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3475 W CHESTER PIKE",
            "address_2": "SUITE 200",
            "city": "NEWTOWN SQUARE",
            "state": "PA",
            "postal_code": "190734280",
            "telephone_number": "610-356-0300",
            "fax_number": "610-356-1981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3475 W CHESTER PIKE",
            "address_2": "SUITE 200",
            "city": "NEWTOWN SQUARE",
            "state": "PA",
            "postal_code": "190734280",
            "telephone_number": "610-356-0300",
            "fax_number": "610-356-1981"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUBURBAN PRIMARY CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-17",
        "last_updated": "2008-05-27",
        "status": "A",
        "authorized_official_last_name": "MCCORMICK",
        "authorized_official_first_name": "KATIE",
        "authorized_official_title_or_position": "CREDENTIALER",
        "authorized_official_telephone_number": "610-356-0300",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA ID",
            "identifier": "085555",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE ID",
            "identifier": "0142949001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newtown Square, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.