VINE STREET MEDICAL AND ASSOCIATES (NPI# 1861921389) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861921389 |
| Entity Type | Organization |
| Organization Name | VINE STREET MEDICAL AND ASSOCIATES |
| Practice Address |
6323 Vine St Philadelphia PA 19139-1032 |
| Practice Telephone | (267) 292-5638 |
| Practice Fax Number | 2672925648 |
| Mailing Telephone | 2672925638 |
| Mailing Fax Number | 2672925648 |
| Enumeration Date | 2017-06-08 |
| Last Update Date | 2017-06-08 |
| Authorized Official Name | SHARI JOHNSON (ADMIN) |
| Authorized Official Telephone | 2672925638 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207QA0401X |
Family Medicine Specialization: Addiction Medicine |
MD032595E | PA | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487181699 | Vine Street Medical and Associates | Chiropractor | 6323 Vine St, Philadelphia, PA 19139-1032 | 2017-05-18 |
| Street Address |
6323 VINE ST |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19139-1032 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932198157 | Mercy Management of Southeastern Pennsylvania | Internal Medicine | 6323 Vine St, Philadelphia, PA 19139-1032 | 2005-10-20 |
| 1487181699 | Vine Street Medical and Associates | Chiropractor | 6323 Vine St, Philadelphia, PA 19139-1032 | 2017-05-18 |
| 1881654614 | Bernadine Lewis | Physician Assistant | 6323 Vine St, Philadelphia, PA 19139-1032 | 2006-03-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598378663 | Suzanne Banning Anderson | Social Worker | Sayre High School, 5800 Walnut St, Philadelphia, PA 19139 | 2020-08-28 |
| 1770192890 | Michael Pappano LLC | Social Worker | 31 South 51st St, Philadelphia, PA 19139 | 2020-07-24 |
| 1912419581 | Christina Lipuma | Dietitian, Registered | 5210 Haverford Ave, Philadelphia, PA 19139 | 2017-11-03 |
| 1538515564 | New Vitae Inc | Public Health or Welfare | 27 S 55th Street, Philadelphia, PA 19139 | 2016-05-09 |
| 1982058681 | Phyllis Mwaura | In Home Supportive Care | 5338 Vine Street, Basement, Philadelphia, PA 19139 | 2016-04-19 |
| 1861879322 | Barbara Joette Hegarty | Counselor | 4508 Chestnut Street, Philadelphia, PA 19139 | 2015-05-04 |
| 1336533454 | Julie Magallanes-montone | Family Medicine | 5201 Haverford Avenue, Philadelphia, PA 19139 | 2015-03-26 |
| 1134494909 | The Children's Hospital of Philadelphia | Pediatrics | 4865 Market Street, Philadelphia, PA 19139 | 2012-03-13 |
| 1467757443 | Nouman Bashir | Dentist | 5139 Chestnut Stree, Philadelphia, PA 19139 | 2011-01-21 |
| 1720396732 | Serena Denise Johnson | Contractor | 5151a Walnut Street, Philadelphia, PA 19139 | 2010-09-24 |
| Find all providers in zip 19139 | ||||
| Taxonomy Code | 207QA0401X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Addiction Medicine |
| A family medicine physician who specializes in the diagnosis and treatment of addictions. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A Certification of Added Qualifications (CAQ) was, but is no longer issued by the American Osteopathic Board of Family Physicians. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821503038 | Philly Newlife Suboxone Clinics | Family Medicine | 3477 Saint Vincent St, Philadelphia, PA 19149-1628 | 2017-12-11 |
| 1740570886 | Germantown Pain Management & Physical Therapy | Family Medicine | 6334 Germantown Ave, Philadelphia, PA 19144-1935 | 2011-04-11 |
| 1629201314 | Cottman & Castor Pain Management | Family Medicine | 1934 Cottman Ave, Philadelphia, PA 19111-3817 | 2009-08-27 |
| 1992948038 | Frankford Medical and Pain Management LLC | Family Medicine | 4911 Frankford Ave, Philadelphia, PA 19124-2617 | 2009-04-17 |
| 1477731974 | Judith Prophete | Family Medicine | 5000 Parkside Ave, Philadelphia, PA 19131-4714 | 2008-02-06 |
| 1033309497 | Sylvia Alfreda Webster | Family Medicine | 112 N Broad St, Rm 821, Philadelphia, PA 19102-1510 | 2007-07-31 |
| 1710109608 | Aviva Fohrer | Family Medicine | 5000 Parkside Ave, Philadelphia, PA 19131-4714 | 2007-05-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851958763 | Hope Recovery Services LLC | Family Medicine | 200 Mcknight Park Dr Ste 201, Pittsburgh, PA 15237-6507 | 2019-05-27 |
| 1992281125 | Aurora Recovery Services, LLC | Family Medicine | 993 Brodhead Rd Ste 201, Moon Twp, PA 15108 | 2018-07-11 |
| 1447609565 | Recovery Care LLC | Family Medicine | 2057 State Route 130 # 3, Jeannette, PA 15644-3801 | 2016-06-09 |
| 1366806358 | Victory Life Health Services | Family Medicine | 95 E High St Ste 104, Waynesburg, PA 15370-1853 | 2016-04-06 |
| 1154662062 | William Francis Hushion I | Family Medicine | 1066 Putnam Blvd, Wallingford, PA 19086-6747 | 2013-03-04 |
| 1649584459 | Meridian Recovery Services Inc | Family Medicine | 2626 Sigsbee St, Erie, PA 16508-1721 | 2010-08-04 |
| 1265754998 | Amc Health | Family Medicine | 2626 Sigsbee Street, Erie, PA 16508-1808 | 2010-02-22 |
| 1144460544 | James Lee Ferguson Jr. | Family Medicine | 100 Highpoint Dr, Suite 102, Chalfont, PA 18914-3926 | 2009-02-24 |
| 1356597850 | Rudolph Edward Merick | Family Medicine | 24 Beech Hills Rd, Jeannette, PA 15644-6601 | 2008-08-15 |
| 1538328927 | Staci Botwin Mulcahy | Family Medicine | 310 Stoke Park Rd, Bethlehem, PA 18017-9429 | 2008-06-02 |
| Find all providers with the same taxonomy | ||||
| City | PHILADELPHIA |
| Zip Code | 19139 |
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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.