Suburban Spine and Orthopedic Center

Primary specialty

Non-Pharmacy Dispensing SiteTaxonomy code 332900000X

License

OS009073L Issued in PA

Legal business name

SUBURBAN SPINE AND ORTHOPEDIC CENTER

Practice address

1204 Baltimore Pike Ste 303
Chadds Ford, PA 19317-7374

Phone

(610) 558-1001

Fax

(610) 558-1180

NPI assigned

Jun 29, 2016

Last updated

Jul 21, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Matthew Legowski

Title

Operations

Phone

(609) 703-5097

Specialties & licenses 2

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Gerard J. Foti, D.O.

  • Orthopaedic Surgery Physician
  • Bryn Mawr, PA
  • NPI 1568424018
  NPD (past)

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

{
    "created_epoch": "1467158400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1982055133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1204 BALTIMORE PIKE STE 303",
            "city": "CHADDS FORD",
            "state": "PA",
            "postal_code": "193177374",
            "telephone_number": "610-558-1001",
            "fax_number": "610-558-1180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1204 BALTIMORE PIKE STE 303",
            "city": "CHADDS FORD",
            "state": "PA",
            "postal_code": "193177374",
            "telephone_number": "610-558-1001",
            "fax_number": "610-558-1180"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "736 Baltimore Pike",
            "address_2": "Suite 3",
            "address_purpose": "LOCATION",
            "city": "Glen Mills",
            "state": "PA",
            "postal_code": "193421074",
            "country_code": "US",
            "telephone_number": "609-703-5097",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SUBURBAN SPINE AND ORTHOPEDIC CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-29",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "LEGOWSKI",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "OPERATIONS",
        "authorized_official_telephone_number": "609-703-5097"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "PA",
            "license": "OS009073L",
            "primary": false
        },
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": "PA",
            "license": "OS009073L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• State Line Health Care LLC
• Magdalena Wilson Stephey, M.S., CCC/SLP-L
• Roy B Stoller, D.O.
• Alicia Petros Stoutland, DDS
• Caleah Streater, LCSW
• Dari K Sweeton, LCSW
• Synergy Chiropractic Wellness
• TBM Ambulance Services
• TBM Health Services LLC (Tom Barnes Mbori)
• Testamente Homehealthcare Services, LLC

• Non-Pharmacy Dispensing Site in Chadds Ford, PA
• Providers in Chadds Ford, PA by specialty
• Non-Pharmacy Dispensing Site in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.