NPIMap

Organization Active NPI

Keystone Orthopaedic Specialists Group LLC

  • Physical Therapist
  • Wyomissing, PA
National Provider Identifier
1891064036
Registry record updated Dec 16, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
KEYSTONE ORTHOPAEDIC SPECIALISTS GROUP LLC
Practice address
1270 Broadcasting Rd
Wyomissing, PA 19610-3203
Phone
(610) 376-5600
Fax
(610) 372-7684
NPI assigned
Dec 16, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2011

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

Authorized official

Name
Dr. Stephen Patrick Banco, M.D.
Title
President
Phone
(610) 372-1140

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

1270 Broadcasting Rd
Wyomissing, PA 19610-3203

Mailing address

1270 Broadcasting Rd
Wyomissing, PA 19610-3203
Phone (610) 376-5600

National Provider Directory

National Provider Directory
Tax ID family
Keystone Orthopaedic Specialists Group LLC2 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.

NPI Registry JSON

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

{
    "created_epoch": "1323993600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1323993600000",
    "number": "1891064036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1270 BROADCASTING RD",
            "city": "WYOMISSING",
            "state": "PA",
            "postal_code": "196103203",
            "telephone_number": "610-376-5600",
            "fax_number": "610-372-7684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1270 BROADCASTING RD",
            "city": "WYOMISSING",
            "state": "PA",
            "postal_code": "196103203",
            "telephone_number": "610-376-5600",
            "fax_number": "610-372-7684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEYSTONE ORTHOPAEDIC SPECIALISTS GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-16",
        "last_updated": "2011-12-16",
        "status": "A",
        "authorized_official_last_name": "BANCO",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "PATRICK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "610-372-1140",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Dec 16, 2011; 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.