Upmc Shadyside

Primary specialty

Non-Pharmacy Dispensing SiteTaxonomy code 332900000X

License

OS008166L Issued in PA

Legal business name

UPMC SHADYSIDE

Practice address

5215 Centre Ave
Pittsburgh, PA 15232

Phone

(412) 623-2561

NPI assigned

Aug 24, 2007

Last updated

Oct 22, 2012By the provider in NPPES

Organization subpart

Yes

Parent organization

MEDVANTX, INCAs reported in NPPES

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

Authorized official

Name

Kenny Heine

Title

Director of Operations

Phone

(858) 625-2990

Specialties & licenses 1

Addresses

Part of

Medvantx Inc

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

{
    "created_epoch": "1187913600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1350864000000",
    "number": "1992998793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5626 OBERLIN DR",
            "address_2": "SUITE 110",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921211705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5215 CENTRE AVE",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "15232",
            "telephone_number": "412-623-2561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UPMC SHADYSIDE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MEDVANTX, INC",
        "enumeration_date": "2007-08-24",
        "last_updated": "2012-10-22",
        "status": "A",
        "authorized_official_last_name": "HEINE",
        "authorized_official_first_name": "KENNY",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "858-625-2990"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": "PA",
            "license": "OS008166L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Upmc Presbyterian Shadyside (Western Psychiatric Institute and Clinic)
• Upmc Presbyterian Shadyside
• Upmc Presbyterian Shadyside
• Upmc Presbyterian Shadyside
• Upmc Senior Communities
• Upmc South Side
• Upmc South Side
• Upmc South Side
• Upmc South Side
• Upmc Southside Transitional

• Non-Pharmacy Dispensing Site in Pittsburgh, PA
• Providers in Pittsburgh, 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 Oct 22, 2012; 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.