NPIMap

Organization Active NPI

Memphis Street Pediatrics LLC

  • Pediatrics Physician
  • Philadelphia, PA
National Provider Identifier
1992800940
Registry record updated Sep 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
MEMPHIS STREET PEDIATRICS LLC
Practice address
3380 Memphis St
Philadelphia, PA 19134-4510
Phone
(215) 426-5566
Fax
(215) 739-7304
NPI assigned
Sep 14, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2010

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

Authorized official

Name
Louise T Holmes
Title
Practice Manager
Phone
(215) 707-1059

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

3380 Memphis St
Philadelphia, PA 19134-4510

Mailing address

3380 Memphis St
Philadelphia, PA 19134-4510
Phone (215) 426-5566

Other names 1

  • Memphis Street Pediatrics Doing business as

National Provider Directory

National Provider Directory

Locations

2301 E Allegheny Ave
#203
Phila, PA 19134
Phone (215) 426-5566

2301 E Allegheny Ave
Ste 203
Philadelphia, PA 19134
Phone (215) 426-5566

Practitioners & affiliated clinicians

Practitioners 4

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": "1158192000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1284508800000",
    "number": "1992800940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3380 MEMPHIS ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191344510",
            "telephone_number": "215-426-5566",
            "fax_number": "215-739-7304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3380 MEMPHIS ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191344510",
            "telephone_number": "215-426-5566",
            "fax_number": "215-739-7304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEMPHIS STREET PEDIATRICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-14",
        "last_updated": "2010-09-15",
        "status": "A",
        "authorized_official_last_name": "HOLMES",
        "authorized_official_first_name": "LOUISE",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "215-707-1059"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Memphis Street Pediatrics",
            "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 Sep 15, 2010; 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.