NPIMap

Organization Active NPI

Fornance Physician Services, Inc

  • Family Medicine Physician
  • North Wales, PA
National Provider Identifier
1972875474
Registry record updated Nov 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
FORNANCE PHYSICIAN SERVICES, INC
Doing business as
NORTH WALES FAMILY MEDICINE
Practice address
212 N Main St
North Wales, PA 19454-3129
Phone
(610) 270-2352
Fax
(610) 270-2358
NPI assigned
Jan 31, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2018

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

Authorized official

Name
Mrs. Vera Burnett-Robins
Title
Director Physician Billing
Phone
(484) 622-7391

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

212 N Main St
North Wales, PA 19454-3129

Mailing address

PO Box 789967
Philadelphia, PA 19178-9967
Phone (484) 622-7395

Other names 1

  • NORTH WALES FAMILY MEDICINE Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040216000037 PA Part B Supplier - Clinic/Group Practice 8527962661 Receives reassigned benefits from 215 practitioners
36 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: King of Prussia, PA; Lansdale, PA; Norristown, PA; North Wales, PA; Plymouth Meeting, PA; East Norriton, PA; Audubon, PA; Blue Bell, PA…

Other NPIs on the same Medicare enrollment 36

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 36

National Provider Directory

National Provider Directory
Tax ID family
Fornance Physician Services Inc28 organizations share this tax ID, including this one

Other organizations with this tax ID 27

Organizations that report the same tax identification number in the National Provider Directory.

View all 27

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1327968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1542153600000",
    "number": "1972875474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 789967",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191789967",
            "telephone_number": "484-622-7395",
            "fax_number": "484-622-7399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 N MAIN ST",
            "city": "NORTH WALES",
            "state": "PA",
            "postal_code": "194543129",
            "telephone_number": "610-270-2352",
            "fax_number": "610-270-2358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORNANCE PHYSICIAN SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-31",
        "last_updated": "2018-11-14",
        "status": "A",
        "authorized_official_last_name": "BURNETT-ROBINS",
        "authorized_official_first_name": "VERA",
        "authorized_official_title_or_position": "DIRECTOR PHYSICIAN BILLING",
        "authorized_official_telephone_number": "484-622-7391",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NORTH WALES FAMILY MEDICINE",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "NORTH WALES FAMILY MEDICINE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in North Wales, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 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.