NPIMap

Organization Active NPI

Saint Vincent Medical Education and Research Institute

  • Family Medicine Physician
  • Erie, PA
National Provider Identifier
1932294022
Registry record updated Nov 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
SAINT VINCENT MEDICAL EDUCATION AND RESEARCH INSTITUTE
Doing business as
Great Lakes Family Medicine
Practice address
3530 Peach St
Erie, PA 16508-2768
Phone
(814) 864-6039
Fax
(814) 864-6760
NPI assigned
Oct 4, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2010

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

Authorized official

Name
Patricia Ballman
Title
Executive Director
Phone
(814) 452-5296

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

3530 Peach St
Erie, PA 16508-2768

Mailing address

3530 Peach St
Suite LL1
Erie, PA 16508-2768
Phone (814) 860-5036

Other names 1

  • Great Lakes Family Medicine Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Saint Vincent Medical E79 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 18

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1288656000000",
    "number": "1932294022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3530 PEACH ST",
            "address_2": "SUITE LL1",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165082768",
            "telephone_number": "814-860-5036",
            "fax_number": "814-860-5063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3530 PEACH ST",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165082768",
            "telephone_number": "814-864-6039",
            "fax_number": "814-864-6760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAINT VINCENT MEDICAL EDUCATION AND RESEARCH INSTITUTE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-04",
        "last_updated": "2010-11-02",
        "status": "A",
        "authorized_official_last_name": "BALLMAN",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "814-452-5296"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Great Lakes Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Erie, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2010; 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.