Active NPI
Trustees of the University of Pennsylvania
Doing business as Penn Medicine at Radnor Endoscopy Facility
- Endoscopy Clinic/Center
- Radnor, PA
National Provider Identifier
1932252228
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endoscopy Clinic/Center
- License
- 1675
- Legal business name
- TRUSTEES OF THE UNIVERSITY OF PENNSYLVANIA
- Doing business as
- Penn Medicine at Radnor Endoscopy Facility
- Practice address
- 250 King of Prussia Rd
Radnor, PA 19087-5220 - Phone
- (610) 902-1500
- NPI assigned
- Jan 19, 2007
- Last updated
- Apr 23, 2020
- Organization subpart
- Yes
- Parent organization
- TRUSTEES OF THE UNIVERSITY OF PENNSYLVANIA
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Chante L Jackson
- Title
- Lead Coordintor
- Phone
- (215) 662-6187
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulatory Surgical Clinic/Center | 261QA1903X | |||
| Endoscopy Clinic/Center | 261QE0800X | 1675 | PA | Primary |
Addresses
Primary practice location
250 King of Prussia Rd
Radnor, PA 19087-5220
Mailing address
250 King of Prussia Rd
Radnor, PA 19087-5220
Phone (610) 902-1500
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1461 | Other | PA | INDEPENDENCE BLUE CROSS |
| 707804 | Other | PA | AETNA U S HEALTHCARE |
Other names 1
- Penn Medicine at Radnor Endoscopy Facility
National Provider Directory
National Provider Directory- Part of
- Hup Dept Pathology la
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169164800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1587600000000",
"number": "1932252228",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "250 KING OF PRUSSIA RD",
"city": "RADNOR",
"state": "PA",
"postal_code": "190875220",
"telephone_number": "610-902-1500"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "250 KING OF PRUSSIA RD",
"city": "RADNOR",
"state": "PA",
"postal_code": "190875220",
"telephone_number": "610-902-1500"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "TRUSTEES OF THE UNIVERSITY OF PENNSYLVANIA",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "TRUSTEES OF THE UNIVERSITY OF PENNSYLVANIA",
"enumeration_date": "2007-01-19",
"last_updated": "2020-04-23",
"certification_date": "2020-04-23",
"status": "A",
"authorized_official_last_name": "JACKSON",
"authorized_official_first_name": "CHANTE",
"authorized_official_middle_name": "L",
"authorized_official_title_or_position": "LEAD COORDINTOR",
"authorized_official_telephone_number": "215-662-6187"
},
"taxonomies": [
{
"code": "261QA1903X",
"taxonomy_group": "",
"desc": "Clinic/Center, Ambulatory Surgical",
"state": null,
"license": null,
"primary": false
},
{
"code": "261QE0800X",
"taxonomy_group": "",
"desc": "Clinic/Center, Endoscopy",
"state": "PA",
"license": "1675",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "INDEPENDENCE BLUE CROSS",
"identifier": "1461",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA U S HEALTHCARE",
"identifier": "707804",
"state": "PA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Penn Medicine at Radnor Endoscopy Facility",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Penn Medicine at Radnor Endoscopy Facility",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Radnor, PA
- Trustees of the University of Pennsylvania
- Trustees of the University of Pennsylvania
- Trustees of the University of Pennsylvania
- Trustees of the University of Pennsylvania
- Trustees of the University of Pennsylvania (Hospital of the University of Pennsylvania - Radnor Pharmacy)
- Trustees of the University of Pennsylvania
- Trustees of the University of Pennsylvania (Hospital of the University of Pennsylvania Radnor Pharmacy)
- Sharon Money Twombly, MED/PT
- Stephen George Underwood, M.D.
- Jessee Klein Valentine, D.O.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.