PENNSYLVANIA PHYSICIANS SERVICES, LLC (NPI# 1265711824) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265711824 |
| Entity Type | Organization |
| Organization Name | PENNSYLVANIA PHYSICIANS SERVICES, LLC |
| Practice Address |
209 W Lancaster Ave Paoli PA 19301-1749 |
| Mailing Address |
3113 Lawton Rd Ste 250 Orlando FL 32803-3517 |
| Practice Telephone | 6106442382 |
| Practice Fax Number | 6106447517 |
| Mailing Telephone | 8888298550 |
| Enumeration Date | 2011-08-12 |
| Last Update Date | 2019-09-20 |
| Authorized Official Name | BRETT KENEFICK (PRESIDENT) |
| Authorized Official Telephone | 8888298550 |
| Is Organization Subpart | Y |
| Parent Organization Name | VAXCARE CORPORATION |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| Street Address |
209 W LANCASTER AVE |
| City | PAOLI |
| State | PA |
| Zip Code | 19301-1749 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548233083 | Barry Herbert Burkhardt | Family Medicine | 209 W Lancaster Ave, Suite 101, Paoli, PA 19301-1749 | 2006-02-07 |
| 1619585577 | Thomas Hughes | Behavioral Analyst | 209 W Lancaster Ave, Paoli, PA 19301-1749 | 2020-07-16 |
| 1396935912 | Joseph A Graversen | Urology | 209 W Lancaster Ave, Suite 200, Paoli, PA 19301-1749 | 2007-07-30 |
| 1922112119 | James R Bollinger, Md PC | Urology | 209 W Lancaster Ave, Suite 200, Paoli, PA 19301-1749 | 2006-08-18 |
| 1336156785 | James Richard Bollinger | Urology | 209 W Lancaster Ave, Suite 200, Paoli, PA 19301-1749 | 2006-08-01 |
| 1538185582 | Barbara B Hackman | Family Medicine | 209 W Lancaster Ave, Suite #101, Paoli, PA 19301-1749 | 2006-07-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588280333 | Mary Callery | Physical Therapy Assistant | 16 Industrial Blvd., Ste. 101, Paoli, PA 19301 | 2020-06-17 |
| 1871097519 | Daniel Malloy-good | Social Worker | 45 Darby Rd Ste E4, Paoli, PA 19301 | 2018-03-19 |
| 1306354774 | Patricia Obilo-azandegbe | Counselor | 30 S Valley Rd Ste 101, Paoli, PA 19301 | 2018-01-18 |
| 1275992877 | Jessica Bernard | Physical Therapist | 40 Darby Rd Ste 1, Paoli, PA 19301 | 2016-02-11 |
| 1730576364 | Ushma Sheth | Podiatrist | 250 W Lancaster Ave Ste 225, Paoli, PA 19301 | 2015-04-21 |
| 1619371432 | Miriam Leslie Brewer | Physical Therapist | 195 W Lancaster Ave #3, Paoli, PA 19301 | 2014-10-22 |
| 1447665393 | Matthew Rementer | Podiatrist | 254 West Lancaster Ave, Paoli, PA 19301 | 2014-06-29 |
| 1720490915 | Edward Anthony Romero | Surgery | 255 W Lancaster Ave Ste 332, Paoli, PA 19301 | 2014-05-22 |
| 1285053421 | Jose Ethan Pulido | Urology | 2 Industrial Blvd Bldg C Ste 120, Paoli, PA 19301 | 2014-04-15 |
| 1093065849 | Kathleen M Canfield | Physician Assistant | 11 Industrial Blvd., Ste 204, Paoli Pointe Med. Office Bldg, Paoli, PA 19301 | 2012-09-19 |
| Find all providers in zip 19301 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083855514 | George T Taylor Iv | Family Medicine | 250 W Lancaster Ave Ste 120, Paoli, PA 19301-1798 | 2009-03-12 |
| 1730298746 | Yolanda Joy Yoder | Family Medicine | 420 W Longest St, Paoli, IN 47454-8821 | 2006-08-30 |
| 1245282235 | Paoli Family Medicine | Family Medicine | 250 Lancaster Ave, Suite 120, Paoli, PA 19301 | 2006-05-17 |
| 1548233083 | Barry Herbert Burkhardt | Family Medicine | 209 W Lancaster Ave, Suite 101, Paoli, PA 19301-1749 | 2006-02-07 |
| 1063490001 | Merlin W Friesen Iv | Family Medicine | 202 Cherry St, Paoli, IN 47454-1108 | 2006-01-09 |
| 1528555703 | Mackenzie Foster | Family Medicine | 250 W Lancaster Ave Ste 120, Paoli, PA 19301-1798 | 2018-04-13 |
| 1710349766 | Fyzah Hussain Qureshi | Family Medicine | 255 W Lancaster Ave, Paoli, PA 19301-1763 | 2016-03-28 |
| 1427430081 | Sergio S. Sales | Family Medicine | 642 W Hospital Rd, Paoli, IN 47454 | 2015-06-19 |
| 1952714040 | Jeffrey Cain Stevens | Family Medicine | 255 W Lancaster Ave Ste 330, Paoli, PA 19301-1766 | 2014-06-05 |
| 1306106836 | Timothy B Mack | Family Medicine | 255 W Lancaster Ave Ste 330, Paoli, PA 19301-1766 | 2012-05-17 |
| Find all providers in PAOLI | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.