Innovative Medical Associates, LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

OS014411 Issued in PA

Legal business name

INNOVATIVE MEDICAL ASSOCIATES, LLC

Practice address

400 Baileys Run LN
Springfield, PA 19064-2143

Phone

(610) 505-8350

Fax

(610) 675-1775

NPI assigned

Feb 12, 2014

Organization subpart

No

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

Authorized official

Name

Kelli Yacono, DONPI 1578721965

Title

Owner/Physician

Phone

(610) 505-8350

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Locations

Practitioners 1

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

• Kelli Yacono, DO

  • Hospitalist Physician
  • Springfield, PA
  • NPI 1578721965

  Internal Medicine

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1392163200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1392163200000",
    "number": "1922422849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 BAILEYS RUN LN",
            "city": "SPRINGFIELD",
            "state": "PA",
            "postal_code": "190642143",
            "fax_number": "610-675-1775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 BAILEYS RUN LN",
            "city": "SPRINGFIELD",
            "state": "PA",
            "postal_code": "190642143",
            "telephone_number": "610-505-8350",
            "fax_number": "610-675-1775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOVATIVE MEDICAL ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-12",
        "last_updated": "2014-02-12",
        "status": "A",
        "authorized_official_last_name": "YACONO",
        "authorized_official_first_name": "KELLI",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "610-505-8350",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "OS014411",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chinenye Iheme, M.D.
• Chimdimma Ilonzo, PHARM.D.
• Imaging Professionals of Pennsylvania PC
• Margaret Imbrogno, MA-CCCSLP
• Nicola Ingram, MSW
• Insppire Limited Liability Company
• Integrated Mental Health Services
• Intercultural Counseling LLC
• Maleha Iqbal, MS, DO
• Barry Jacobs, PSY.D

• Internal Medicine Physician in Springfield, PA
• Providers in Springfield, PA by specialty
• Internal Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2014; 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.