NPIMap

Organization Active NPI

Methodist Associates in Healthcare, Inc.

Doing business as Jefferson Community Physicians - Dermatology

  • Dermatology Physician
  • Philadelphia, PA
National Provider Identifier
1922570498
Registry record updated Jun 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
METHODIST ASSOCIATES IN HEALTHCARE, INC.
Doing business as
Jefferson Community Physicians - Dermatology
Practice address
3 Crescent Dr FL 2
Philadelphia, PA 19112-1016
Phone
(215) 503-7090
Fax
(215) 503-3210
NPI assigned
Dec 21, 2018
Last updated
Jun 13, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
METHODIST ASSOCIATES IN HEALTHCARE, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 13, 2024

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

Authorized official

Name
Valerie Yvette Bright-Butler
Title
Associate Director, Credentialing
Phone
(215) 955-9451

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207N00000X Primary
Dermatopathology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207ND0900X
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X

Addresses

Primary practice location

3 Crescent Dr FL 2
Philadelphia, PA 19112-1016

Mailing address

PO Box 828937
Philadelphia, PA 19182-8937
Phone (215) 503-1240

Other names 1

  • Jefferson Community Physicians - Dermatology Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Methodist Anesthesia PR38 organizations share this tax ID, including this one
Part of
Methodist Anesthesia PR

Other organizations with this tax ID 37

Organizations that report the same tax identification number in the National Provider Directory.

View all 37

Locations

615 Chestnut St
Fl 14
Philadelphia, PA 19106
Phone (215) 955-1175

NPI Registry JSON

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

{
    "created_epoch": "1545350400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718236800000",
    "number": "1922570498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 828937",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191828937",
            "telephone_number": "215-503-1240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 CRESCENT DR FL 2",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191121016",
            "telephone_number": "215-503-7090",
            "fax_number": "215-503-3210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "METHODIST ASSOCIATES IN HEALTHCARE, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "METHODIST ASSOCIATES IN HEALTHCARE, INC.",
        "enumeration_date": "2018-12-21",
        "last_updated": "2024-06-13",
        "certification_date": "2024-06-13",
        "status": "A",
        "authorized_official_last_name": "BRIGHT-BUTLER",
        "authorized_official_first_name": "VALERIE",
        "authorized_official_middle_name": "YVETTE",
        "authorized_official_title_or_position": "ASSOCIATE DIRECTOR, CREDENTIALING",
        "authorized_official_telephone_number": "215-955-9451"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207ND0900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology, Dermatopathology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jefferson Community Physicians - Dermatology",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Jefferson Community Physicians - Dermatology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jun 13, 2024; 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.