INTEGRATED MEDICAL GROUP PC NPI 1184076663

NPI Information

  • NPI: 1184076663
  • Provider Name: INTEGRATED MEDICAL GROUP, PC
  • Classification: Nurse Practitioner - 363LF0000X
  • Specialization: Family
  • Entity Type: Organization
  • CLIA Number: 39D0205093
  • Address: 805 N RICHMOND ST
    FLEETWOOD, PA
    ZIP 19522
  • Phone: (610) 944-0464

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NPI Details

INTEGRATED MEDICAL GROUP, PC is a family nurse practitioner in Fleetwood, PA. INTEGRATED MEDICAL GROUP, PC NPI is 1184076663. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

805 N RICHMOND ST
FLEETWOOD, PA
ZIP 19522-058
Phone: (610) 944-0464

The provider's authorized official is Barbara J Mcculley .
The authorized official title is Office Manager and has the following contact phone number (610) 944-0464.

The CLIA number assigned to this NPI record is 39D0205093 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/7/2016 and was last updated on 7/7/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LF0000XNurse PractitionerFamilySP016169PENNSYLVANIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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