BETHANY BLUM (NPI# 1710334404) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710334404 |
| Entity Type | Individual |
| Full Name | BETHANY BLUM |
| Credential | DO |
| Practice Address |
4636 Woodland Ave Philadelphia PA 19143-3854 |
| Mailing Address |
4921 Osage Ave Philadelphia PA 19143-1608 |
| Practice Telephone | 2157926161 |
| Mailing Telephone | 2157926161 |
| Mailing Fax Number | 7178644002 |
| Enumeration Date | 2016-05-23 |
| Last Update Date | 2020-01-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 204D00000X | Neuromusculoskeletal Medicine & OMM | OS020290 | PA | Allopathic & Osteopathic Physicians |
| Street Address |
4636 WOODLAND AVE |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19143-3854 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174074033 | Jeremiah Bush | Physician Assistant | 4636 Woodland Ave, Apt 2, Philadelphia, PA 19143-3854 | 2016-10-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215554142 | Trusted Hands Care Professionals LLC | In Home Supportive Care | 1130 South Paxon Street, Philadelphia, PA 19143 | 2020-06-26 |
| 1477189140 | Kareemah Anjail Abdullah | Counselor | 5307 Chelen Ave, Philadelphia, PA 19143 | 2020-03-13 |
| 1336604024 | Mohamed Keita | Non-emergency Medical Transport (VAN) | 5030 Warrington Avenue, Philadelphia, PA 19143 | 2019-02-06 |
| 1366924011 | Whitney Tamika Carter | Specialist/Technologist | 5526 Ridgewood St, Philadelphia, PA 19143 | 2018-08-29 |
| 1639662190 | Mattew Muchnick | Physical Therapist | 4730 Hazel Ave 2r, Philadelphia, PA 19143 | 2018-06-10 |
| 1750883062 | Optimal Support for Everyday Lives | Case Management | 5800 Springfield Avenue, Philadelphia, PA 19143 | 2018-03-02 |
| 1205352671 | New Visions Case Management & Consulting, LLC | Social Worker | 726 S 55th Street, Philadelphia, PA 19143 | 2017-08-17 |
| 1104342583 | Mercy Management of Southeastern Pennsylvania | Orthopaedic Surgery | 501 S 54th St Ste 28, Phila, PA 19143 | 2017-08-17 |
| 1093238388 | Blessed Hands Home Care Agency L.L.C. | Home Health | 433 S. 57th Street, Phila, PA 19143 | 2017-07-19 |
| 1891216529 | Ashley Seiver | Occupational Therapist | 923 S. 46th Street, Philadelphia, PA 19143 | 2017-07-03 |
| Find all providers in zip 19143 | ||||
| Taxonomy Code | 204D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Neuromusculoskeletal Medicine & OMM |
| The Neuromusculoskeletal Medicine and Osteopathic Manipulative Medicine physician directs special attention to the neuromusculoskeletal system and its interaction with other body systems. Neuromusculoskeletal Medicine and Osteopathic Manipulative Medicine encompasses increased knowledge and understanding of osteopathic principles and practice and heightened technical skills of osteopathic manipulative medicine, and integrates each of these into the management of pediatric, adolescent, adult, and geriatric patients. |
| Notes: Source: American Osteopathic Association, 2017 [7/1/2017: added definition] - Additional Resources: American Osteopathic Board of Neuromusculoskeletal Medicine, 2017, http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295097376 | Meghna M Patel | Neuromusculoskeletal Medicine & OMM | 4190 City Ave Ste 320, Philadelphia, PA 19131-1633 | 2012-06-13 |
| 1497014070 | Andrew M Levin | Neuromusculoskeletal Medicine & OMM | 4190 City Ave Ste 330, Philadelphia, PA 19131-1633 | 2012-05-16 |
| 1164648846 | Mitchell S Mednick | Neuromusculoskeletal Medicine & OMM | 1514 E Moyamensing Ave, Philadelphia, PA 19147 | 2007-04-18 |
| 1063545838 | Gerald Skobinsky PC | Neuromusculoskeletal Medicine & OMM | 6615 Torresdale Ave, Philadelphia, PA 19135-2827 | 2007-03-13 |
| 1457658015 | Donald Lee Allison II | Neuromusculoskeletal Medicine & OMM | 4190 City Ave, Suite 330, Philadelphia, PA 19131-1626 | 2011-02-17 |
| 1023140605 | Lauren Noto Bell | Neuromusculoskeletal Medicine & OMM | 4190 City Ave, Philadelphia, PA 19131-1626 | 2007-03-10 |
| 1790715001 | Nicholas M Renzi | Neuromusculoskeletal Medicine & OMM | 1900 S Broad St, Philadelphia, PA 19145-2304 | 2006-07-03 |
| 1992742977 | David B Fuller | Neuromusculoskeletal Medicine & OMM | 4190 City Ave, Philadelphia, PA 19131-1626 | 2006-05-31 |
| 1457353336 | Evan A. Nicholas | Neuromusculoskeletal Medicine & OMM | 4190 City Line Ave, Philadelphia, PA 19131-1626 | 2005-08-11 |
| 1639171598 | Alexander S. Nicholas | Neuromusculoskeletal Medicine & OMM | 4190 City Line Ave, Philadelphia, PA 19131-1626 | 2005-08-11 |
| Find all providers in PHILADELPHIA | ||||
| City | PHILADELPHIA |
| Zip Code | 19143 |
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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.