Vine Street Medical and Associates

Primary specialty

Addiction Medicine (Family Medicine) PhysicianTaxonomy code 207QA0401X

License

MD032595E Issued in PA

Legal business name

VINE STREET MEDICAL AND ASSOCIATES

Practice address

6323 Vine St
Philadelphia, PA 19139-1032

Phone

(267) 292-5638

Fax

(267) 292-5648

NPI assigned

Jun 8, 2017

Organization subpart

No

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

Authorized official

Name

Shari Johnson

Title

Admin

Phone

(267) 292-5638

Specialties & licenses 1

Addresses

Tax ID family

Vine Street Medical and Associates2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Vine Street Medical and Associates

  • Chiropractor
  • Philadelphia, PA
  • NPI 1487181699
  NPD tax ID

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

{
    "created_epoch": "1496880000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1861921389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6323 VINE ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191391032",
            "telephone_number": "267-292-5638",
            "fax_number": "267-292-5648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6323 VINE ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191391032",
            "telephone_number": "267-292-5638",
            "fax_number": "267-292-5648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VINE STREET MEDICAL AND ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-08",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "SHARI",
        "authorized_official_title_or_position": "ADMIN",
        "authorized_official_telephone_number": "267-292-5638"
    },
    "taxonomies": [
        {
            "code": "207QA0401X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Addiction Medicine",
            "state": "PA",
            "license": "MD032595E",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vincera Orthopedics
• Vincera Rehab, LLC
• Vincera Surgery Center, LLC
• Stacey Vinci, MA, LMFT
• Vine Street Medical and Associates
• Taylor Viniarski
• Kyle Holmberg Vining, D.D.S.
• Marvin Vinluan, CRNA
• Lisa Vinnacombe, MSS, MLSP, LCSW
• Christopher Lawrence Vinnard, M.D.

• Addiction Medicine (Family Medicine) Physician in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Addiction Medicine (Family Medicine) Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.