Organization Active NPI

Fox Chase Pediatrics,LLC

  • Pediatrics Physician
  • Philadelphia, PA
National Provider Identifier
1912947607
Registry record updated Oct 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
FOX CHASE PEDIATRICS,LLC
Practice address
7500 Central Avenue
Suite 205
Philadelphia, PA 19111-2432
Phone
(215) 728-7711
Fax
(215) 725-2795
NPI assigned
Jun 8, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2016

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

Authorized official

Name
Dr. Jeffrey Ettinger, M.D.NPI 1396737797
Title
Partner
Phone
(215) 728-7711

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

7500 Central Avenue
Suite 205
Philadelphia, PA 19111-2432

Mailing address

7500 Central Avenue
Suite 205
Philadelphia, PA 19111-2432
Phone (215) 728-7711

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
39D0199133Fox Chase Pediatrics7500 Central Ave Suite 205, Philadelphia, PA 19111Certificate of waiverApr 11, 2027

National Provider Directory

National Provider Directory

Locations

7500 Central Ave
Ste 205
Philadelphia, PA 19111
Phone (215) 728-7711

Practitioners & affiliated clinicians

Practitioners 9

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

NPI Registry JSON

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1477008000000",
    "number": "1912947607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7500 CENTRAL AVENUE",
            "address_2": "SUITE 205",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191112432",
            "telephone_number": "215-728-7711",
            "fax_number": "215-725-2795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7500 CENTRAL AVENUE",
            "address_2": "SUITE 205",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191112432",
            "telephone_number": "215-728-7711",
            "fax_number": "215-725-2795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOX CHASE PEDIATRICS,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-08",
        "last_updated": "2016-10-21",
        "status": "A",
        "authorized_official_last_name": "ETTINGER",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "215-728-7711",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.