Temple University of the Commonwealth System of Higher Education

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

TEMPLE UNIVERSITY OF THE COMMONWEALTH SYSTEM OF HIGHER EDUCATION

Practice address

3601 A St
Philadelphia, PA 19134-1043

Phone

(215) 707-6605

Fax

(215) 707-6106

NPI assigned

Oct 14, 2005

Organization subpart

No

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

Authorized official

Name

Tonya Woodard

Title

Credentialing/Manager

Phone

(215) 707-3911

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Temple Pediatric Physicians Doing business as

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

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

{
    "created_epoch": "1129248000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529020800000",
    "number": "1942299706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2450 W HUNTING PARK AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191291302",
            "telephone_number": "215-707-6605",
            "fax_number": "215-707-6443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 A ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191341043",
            "telephone_number": "215-707-6605",
            "fax_number": "215-707-6106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TEMPLE UNIVERSITY OF THE COMMONWEALTH SYSTEM OF HIGHER EDUCATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-14",
        "last_updated": "2018-06-15",
        "status": "A",
        "authorized_official_last_name": "WOODARD",
        "authorized_official_first_name": "TONYA",
        "authorized_official_title_or_position": "CREDENTIALING/MANAGER",
        "authorized_official_telephone_number": "215-707-3911"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007780130627",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Temple Pediatric Physicians",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Temple Pediatric Physicians",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Temple University of the Commonwealth System of Higher Education
• Temple University of the Commonwealth System of Higher Education
• Temple University of the Commonwealth System of Higher Education
• Temple University of the Commonwealth System of Higher Education
• Temple University of the Commonwealth System of Higher Education
• Temple University of the Commonwealth System of Higher Education
• Temple University of the Commonwealth System of Higher Education
• Temple University of the Commonwealth System of Higher Education
• Temple University of the Commonwealth System of Higher Education
• Temple University Ophthalmology

• Pediatrics Physician in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Pediatrics Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2018; 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.