Individual provider Active NPI

John P Scanlon, D.P.M.

  • Podiatrist
  • Philadelphia, PA
National Provider Identifier
1962430702
Registry record updated Jan 29, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
SC002365L Issued in PA
Practice address
8815 Germantown Ave
Suite 11
Philadelphia, PA 19118-2722
Phone
(215) 247-0879
Fax
(214) 247-7014
NPI assigned
Jun 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X SC002365L PA Primary

Addresses

Primary practice location

8815 Germantown Ave
Suite 11
Philadelphia, PA 19118-2722

Mailing address

8815 Germantown Ave
Suite 11
Philadelphia, PA 19118-2722
Phone (215) 247-0879

Other identifiers 1

IdentifierTypeStateIssuer
0008700540002MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110330000899 PA Practitioner - Podiatry 8527061217 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Chestnut Hill Podiatry Associates,P.C. Podiatrist CurrentSince Jan 1, 2000 Accepting new patients

Locations

8815 Germantown Ave
Ste 11
Philadelphia, PA 19118
Phone (215) 247-0879

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/78452970-88d1-4fec-b2cf-4da4ec4eae0d/

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359417600000",
    "number": "1962430702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8815 GERMANTOWN AVE",
            "address_2": "SUITE 11",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191182722",
            "telephone_number": "215-247-0879",
            "fax_number": "214-247-7014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8815 GERMANTOWN AVE",
            "address_2": "SUITE 11",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191182722",
            "telephone_number": "215-247-0879",
            "fax_number": "214-247-7014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCANLON",
        "first_name": "JOHN",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-29",
        "last_updated": "2013-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "PA",
            "license": "SC002365L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0008700540002",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.