Organization Active NPI

Tower Health Medical Group

  • Sports Medicine (Family Medicine) Physician
  • Wyomissing, PA
National Provider Identifier
1891036166
Registry record updated Jun 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
Legal business name
TOWER HEALTH MEDICAL GROUP
Practice address
1350 Broadcasting Rd Ste 201
Wyomissing, PA 19610-3229
Phone
(610) 685-9600
Fax
(610) 685-6700
NPI assigned
Mar 11, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2019

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

Authorized official

Name
Gary Conner
Title
Senior VP & Cfo
Phone
(484) 628-8181

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Family Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207QS0010X Primary
Sports Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RS0010X

Addresses

Primary practice location

1350 Broadcasting Rd Ste 201
Wyomissing, PA 19610-3229

Mailing address

PO Box 13579
Reading, PA 19612-3579

Other identifiers 1

IdentifierTypeStateIssuer
072790OtherPAMEDICARE PTAN

Other names 1

  • Sports Medicine - Tower Health Medical Group Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040311000072 PA Part B Supplier - Clinic/Group Practice 7618889213 Receives reassigned benefits from 1,612 practitioners
This NPI is an additional NPI on the enrollment
Practice locations: West Lawn, PA; Phoenixville, PA; West Reading, PA; Womelsdorf, PA; Wyomissing, PA; Sinking Spring, PA; Bernville, PA; Birdsboro, PA…

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 25

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

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1362960000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560729600000",
    "number": "1891036166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13579",
            "city": "READING",
            "state": "PA",
            "postal_code": "196123579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 BROADCASTING RD STE 201",
            "city": "WYOMISSING",
            "state": "PA",
            "postal_code": "196103229",
            "telephone_number": "610-685-9600",
            "fax_number": "610-685-6700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOWER HEALTH MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-11",
        "last_updated": "2019-06-17",
        "status": "A",
        "authorized_official_last_name": "CONNER",
        "authorized_official_first_name": "GARY",
        "authorized_official_title_or_position": "SENIOR VP & CFO",
        "authorized_official_telephone_number": "484-628-8181"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Sports Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RS0010X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Sports Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "072790",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sports Medicine - Tower Health Medical Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wyomissing, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2019; 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.