Erie Medical Specialty Clinic, PC

Primary specialty

SpecialistTaxonomy code 174400000X

License

MD025800E Issued in PA

Legal business name

ERIE MEDICAL SPECIALTY CLINIC, PC

Practice address

104 E 2ND St
Third Floor
Erie, PA 16507-1532

Phone

(814) 877-5564

Fax

(814) 877-5561

NPI assigned

Mar 14, 2007

Organization subpart

No

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

Authorized official

Name

Miss Marybeth Martin

Title

Manager, Clinical Assistant

Phone

(814) 877-5564

Specialties & licenses 1

Addresses

Locations

Practitioners 3

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

• Jeanne Anne Bauman, MD

  • Diagnostic Radiology Physician
  • Erie, PA
  • NPI 1447230644
  NPD (past)
• Carol Ann Lyons, MD

  • Diagnostic Radiology Physician
  • Erie, PA
  • NPI 1407846702
  NPD (past)
• John Cornelius Lyons, MD

  • Adult Reconstructive Orthopaedic Surgery Physician
  • Erie, PA
  • NPI 1477544583
  NPD (past)

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

{
    "created_epoch": "1173830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1861525263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 E 2ND ST",
            "address_2": "THIRD FLOOR",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165071532",
            "telephone_number": "814-877-5564",
            "fax_number": "814-877-5561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 E 2ND ST",
            "address_2": "THIRD FLOOR",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165071532",
            "telephone_number": "814-877-5564",
            "fax_number": "814-877-5561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ERIE MEDICAL SPECIALTY CLINIC, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "MARYBETH",
        "authorized_official_title_or_position": "MANAGER, CLINICAL ASSISTANT",
        "authorized_official_telephone_number": "814-877-5564",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "PA",
            "license": "MD025800E",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erie Imaging, LLC
• Erie Independence House, Inc.
• Erie Independence House, Inc.
• Erie Medical & Rehab Center Inc
• Erie Medical Specialty Clinic, PC
• Erie Operating LLC
• Erie Ops LLC
• Erie Osteopathic Medicine, LLC
• Erie Pharmacy
• Erie Physician Network-Upmc,Inc

• Specialist in Erie, PA
• Providers in Erie, PA by specialty
• Specialist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.