Organization Active NPI

Univ of Penn - OB-GYN

  • Reproductive Endocrinology Physician
  • Philadelphia, PA
National Provider Identifier
1861528754
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Reproductive Endocrinology PhysicianTaxonomy code 207VE0102X
Legal business name
UNIV OF PENN - OB-GYN
Practice address
3701 Market St
7TH and 8TH Floor
Philadelphia, PA 19104-5502
Phone
(215) 662-6100
NPI assigned
Feb 26, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Elizabeth Johnston
Title
Executive Director
Phone
(215) 662-7583

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Reproductive Endocrinology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207VE0102X Primary

Addresses

Primary practice location

3701 Market St
7TH and 8TH Floor
Philadelphia, PA 19104-5502

Mailing address

3624 Market St
Suite 560W
Philadelphia, PA 19104-2614
Phone (215) 662-2286

Other identifiers 9

IdentifierTypeStateIssuer
039030OtherPABLUE SHIELD
24199OtherPAHEALTHPARTNERS
1007448840MedicaidPA
490613OtherPAAETNA
0052759000OtherPAKEYSTONE
273253OtherPAMAMSI
7298609MedicaidNJ
1012028OtherPAMERCY
2Y20350OtherPAHEALTHNET

National Provider Directory

National Provider Directory

Locations

3701 Market St
Fl 7
Philadelphia, PA 19104
Phone (215) 349-5200

NPI Registry JSON

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

{
    "created_epoch": "1172448000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1861528754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3624 MARKET ST",
            "address_2": "SUITE 560W",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191042614",
            "telephone_number": "215-662-2286",
            "fax_number": "215-615-0500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3701 MARKET ST",
            "address_2": "7TH AND 8TH FLOOR",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191045502",
            "telephone_number": "215-662-6100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIV OF PENN - OB-GYN",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JOHNSTON",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "215-662-7583"
    },
    "taxonomies": [
        {
            "code": "207VE0102X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology, Reproductive Endocrinology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "039030",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHPARTNERS",
            "identifier": "24199",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007448840",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "490613",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE",
            "identifier": "0052759000",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAMSI",
            "identifier": "273253",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7298609",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MERCY",
            "identifier": "1012028",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "2Y20350",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • 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.