Phillymedclub PLLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

PHILLYMEDCLUB PLLC

Practice address

1300 N 2ND St Ofc 101
Philadelphia, PA 19122-4594

Phone

(215) 776-7308

NPI assigned

May 5, 2022

Last updated

May 5, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Wayne Christopher Raneiro, MDNPI 1790149573

Title

Cmo

Phone

(215) 776-7308

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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.

• Wayne Christopher Raneiro, M.D.

  • Family Medicine Physician
  • Springfield, PA
  • NPI 1790149573
  NPD Authorized official

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

{
    "created_epoch": "1651708800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1651708800000",
    "number": "1912642703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 N 2ND ST OFC 101",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191224594",
            "telephone_number": "215-776-7308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 N 2ND ST OFC 101",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191224594",
            "telephone_number": "215-776-7308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHILLYMEDCLUB PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-05",
        "last_updated": "2022-05-05",
        "certification_date": "2022-05-05",
        "status": "A",
        "authorized_official_last_name": "RANEIRO",
        "authorized_official_first_name": "WAYNE",
        "authorized_official_middle_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "CMO",
        "authorized_official_telephone_number": "215-776-7308",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Philly Speech and Language LLC
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• Philly Spine Center Incorporated
• Philly Wellness Center LLC
• Phillycare Coaching LLC
• Philmont Homecare, LLC
• Linda Philogene, MSW,LCSW
• Matthew Miller Philp, MD
• Philpot Care Givers LLC
• Brianna Phipps, LSW

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2022; 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.