NPIMap

Organization Active NPI

Integrated Medical Group, P.C.

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Reading, PA
National Provider Identifier
1881341303
Registry record updated Dec 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X
Legal business name
INTEGRATED MEDICAL GROUP, P.C.
Practice address
2211 Quarry Dr Ste E52
Reading, PA 19609-1162
Phone
(610) 396-5163
NPI assigned
Mar 4, 2022
Last updated
Dec 9, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2022

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

Authorized official

Name
Kimberly Walsh
Title
Ceo
Phone
(570) 622-5455

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X NU Primary

Addresses

Primary practice location

2211 Quarry Dr Ste E52
Reading, PA 19609-1162

Mailing address

82 Tunnel Rd
Pottsville, PA 17901-3869
Phone (570) 622-5455

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220909000814 PA DME Supplier - Physician - Orthopedic/Orthopedic Surgery 1355247180 Practice locations: Reading, PA

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Integrated Medical Grou9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

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

Locations (25 of 26)

805 N Richmond St
Ste 101
Fleetwood, PA 19522
Phone (610) 944-0464

2170 Noll Dr
Lancaster, PA 17603
Phone (610) 396-5163

1001 James Dr
Leesport, PA 19533
Phone (215) 237-2103

210 Sunbury St
Minersville, PA 17954
Phone (570) 544-9123

6 S Oak St
Mount Carmel, PA 17851
Phone (570) 339-2636

209 E Market St
Orwigsburg, PA 17961
Phone (272) 639-5035

8 Oak Grove Rd
Ste 1
Pine Grove, PA 17963
Phone (570) 345-3321

100 E Union St
Pottsville, PA 17901
Phone (570) 622-8903

100 Schuylkill Medical Plz
Ste 203
Pottsville, PA 17901
Phone (570) 621-5005

13 S Centre St
Pottsville, PA 17901
Phone (570) 628-0800

407 W Market St
Pottsville, PA 17901
Phone (570) 622-2341

48 Tunnel Rd
Ste 101
Pottsville, PA 17901
Phone (570) 622-2245

48 Tunnel Rd
Ste 201
Pottsville, PA 17901
Phone (570) 624-4128

48 Tunnel Rd
Ste 204
Pottsville, PA 17901
Phone (570) 622-0200

495 N Claude a Lord Blvd
Pottsville, PA 17901
Phone (570) 516-9858

700 Schuylkill Manor Rd
Ste 1A
Pottsville, PA 17901
Phone (570) 622-8903

700 Schuylkill Manor Rd
Ste 5A
Pottsville, PA 17901
Phone (570) 516-9444

2211 Quarry Dr
Ste E52
Reading, PA 19609
Phone (610) 372-7200

555 Raymond St
Reading, PA 19605
Phone (610) 921-1111

6 Hearthstone Ct
Ste 201
Reading, PA 19606
Phone (610) 779-9550

4 S Greenview Rd
Schuylkill Haven, PA 17972
Phone (570) 366-7337

680 E Main St
Schuylkill Haven, PA 17972
Phone (570) 385-2860

531 N Franklin St
#A
Shamokin, PA 17872
Phone (570) 648-0000

224 Claremont Ave
Tamaqua, PA 18252
Phone (570) 628-2229

2211 Quarry Dr
Ste E55
West Lawn, PA 19609
Phone (570) 516-9858

Practitioners & affiliated clinicians

Practitioners 155

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 155

NPI Registry JSON

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

{
    "created_epoch": "1646352000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670544000000",
    "number": "1881341303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "82 TUNNEL RD",
            "city": "POTTSVILLE",
            "state": "PA",
            "postal_code": "179013869",
            "telephone_number": "570-622-5455",
            "fax_number": "570-622-5493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2211 QUARRY DR STE E52",
            "city": "READING",
            "state": "PA",
            "postal_code": "196091162",
            "telephone_number": "610-396-5163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATED MEDICAL GROUP, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-04",
        "last_updated": "2022-12-09",
        "certification_date": "2022-12-09",
        "status": "A",
        "authorized_official_last_name": "WALSH",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "570-622-5455"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Reading, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2022; 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.