NPIMap

Organization Active NPI

Mercy Management of Sepa

  • Family Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1972027688
Registry record updated Aug 3, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
MERCY MANAGEMENT OF SEPA
Practice address
501 S 54TH St Ste 26
Philadelphia, PA 19143-1900
Phone
(215) 748-9200
Fax
(215) 748-9307
NPI assigned
Aug 3, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2017

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

Authorized official

Name
Amiee Brennan
Title
Credentialing Supervisor
Phone
(610) 567-6964

Specialties & licenses 1

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

Addresses

Primary practice location

501 S 54TH St Ste 26
Philadelphia, PA 19143-1900

Mailing address

1 W Elm St
Conshohocken, PA 19428-4108
Phone (610) 567-6964

Other names 1

  • MMSEPA P PCP 54th Office Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1501718400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1501718400000",
    "number": "1972027688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 W ELM ST",
            "city": "CONSHOHOCKEN",
            "state": "PA",
            "postal_code": "194284108",
            "telephone_number": "610-567-6964",
            "fax_number": "610-567-5420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 S 54TH ST STE 26",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191431900",
            "telephone_number": "215-748-9200",
            "fax_number": "215-748-9307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCY MANAGEMENT OF SEPA",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-03",
        "last_updated": "2017-08-03",
        "status": "A",
        "authorized_official_last_name": "BRENNAN",
        "authorized_official_first_name": "AMIEE",
        "authorized_official_title_or_position": "CREDENTIALING SUPERVISOR",
        "authorized_official_telephone_number": "610-567-6964"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MMSEPA P PCP 54th Office",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2017; 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.