NPI Code Detail JSON Logo

1689227209 NPI number — MERCY MANAGEMENT OF SOUTHEASTERN PENNSYLVANI

NPI Number: 1689227209
Health Care Provider/Practitioner: MERCY MANAGEMENT OF SOUTHEASTERN PENNSYLVANI

Information about “1689227209” NPI (MERCY MANAGEMENT OF SOUTHEASTERN PENNSYLVANI) exists in 1689227209 in HTML format HTML  |  1689227209 in plain Text format TXT  |  1689227209 in PDF (Portable Document Format) PDF  |  1689227209 in an XML format XML  formats.

NPI Number : 1689227209 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1689227209",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "Y",
    "ParentOrgLBN": "MERCY ACCOUNTABLE CARE, LLC",
    "ParentOrgTIN": null,
    "OrgName": "MERCY MANAGEMENT OF SOUTHEASTERN PENNSYLVANI",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": "6",
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "41 UNIVERSITY DR STE 106",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "NEWTOWN",
    "MailingAddressStateName": "PA",
    "MailingAddressPostalCode": "18940-1873",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": null,
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "5901 MARKET ST",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "PHILADELPHIA",
    "PracticeLocationAddressStateName": "PA",
    "PracticeLocationAddressPostalCode": "19139-3117",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "413-262-6762",
    "PracticeLocationAddressFaxNumber": "610-567-5495",
    "EnumerationDate": "07/23/2019",
    "LastUpdateDate": "04/22/2021",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "CARUSO",
    "AuthorizedOfficialFirstName": "JOHN",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "PRESIDENT",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": "215-710-2651",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "207R00000X",
        "TaxonomyName": "Internal Medicine Physician",
        "LicenseNumber": null,
        "LicenseNumberStateCode": null,
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": {
        "HealthcareProviderTaxonomyGroupName": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
        "HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
      }
    }
  }
}
                
            

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