NPIMap

Organization Active NPI

Penn Medical Group, P.C.

  • Family Medicine Physician
  • Allentown, PA
National Provider Identifier
1932253002
Registry record updated Nov 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
PENN MEDICAL GROUP, P.C.
Practice address
780 N Krocks Rd Ste 101a
Allentown, PA 18106-9075
Phone
(610) 365-3354
NPI assigned
Jan 23, 2007
Last updated
Nov 19, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2019

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

Authorized official

Name
Dr. Peter J Baddick III, D.O.NPI 1215993928
Title
Owner, Executive Director
Phone
(570) 386-4171

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary
Internal Medicine Physician 207R00000X

Addresses

Primary practice location

780 N Krocks Rd Ste 101a
Allentown, PA 18106-9075

Mailing address

780 N Krocks Rd Ste 101a
Allentown, PA 18106-9075
Phone (610) 365-3354

Other practice location 1

2175 Blakeslee Boulevard Dr W
Lehighton, PA 18235-9776
Phone (570) 386-4171

Other identifiers 4

IdentifierTypeStateIssuer
0019475840006MedicaidPA
1629038468OtherPADR. OGBOLU NPI
0015989840002MedicaidPA
1215993928OtherPADR. BADDICK NPI

National Provider Directory

National Provider Directory

Locations

780 N Krocks Rd
Ste 101A
Allentown, PA 18106
Phone (610) 365-3354

2175 Blakeslee Boulevard Dr W
Lehighton, PA 18235
Phone (570) 386-4171

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1574121600000",
    "number": "1932253002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "780 N KROCKS RD STE 101A",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181069075",
            "telephone_number": "610-365-3354",
            "fax_number": "610-365-3361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "780 N KROCKS RD STE 101A",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181069075",
            "telephone_number": "610-365-3354"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2175 Blakeslee Boulevard Dr W",
            "address_purpose": "LOCATION",
            "city": "Lehighton",
            "state": "PA",
            "postal_code": "182359776",
            "country_code": "US",
            "telephone_number": "570-386-4171",
            "fax_number": "570-386-2429",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PENN MEDICAL GROUP, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-23",
        "last_updated": "2019-11-19",
        "status": "A",
        "authorized_official_last_name": "BADDICK",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER, EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "570-386-4171",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0019475840006",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DR. OGBOLU NPI",
            "identifier": "1629038468",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0015989840002",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DR. BADDICK NPI",
            "identifier": "1215993928",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Allentown, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2019; 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.