INTEGRATED MEDICAL GROUP P C NPI 1336102268

NPI Information

  • NPI: 1336102268
  • Provider Name: INTEGRATED MEDICAL GROUP P C
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Organization
  • Address: 82 TUNNEL RD
    POTTSVILLE, PA
    ZIP 17901
  • Phone: (570) 622-5455

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NPI Details

INTEGRATED MEDICAL GROUP P C is a family medicine in Pottsville, PA. The provider is 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. INTEGRATED MEDICAL GROUP P C NPI is 1336102268. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

82 TUNNEL RD
POTTSVILLE, PA
ZIP 17901-869
Phone: (570) 622-5455
Fax: (570) 622-5493

The provider's authorized official is Jennifer Boyer .
The authorized official title is Billing Manager and has the following contact phone number (570) 622-5455.

The enumeration date for this NPI number is 4/11/2006 and was last updated on 2/10/2016.

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
1207R00000XInternal MedicineNo
2208000000XPediatricsNo
3291U00000XClinical Medical LaboratoryNo
4363A00000XPhysician AssistantNo
5363L00000XNurse PractitionerNo
6207KA0200XAllergy & ImmunologyAllergyNo
7207Q00000XFamily MedicineYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1583056MEDICARE PINPENNSYLVANIA
2100775174MEDICAIDPENNSYLVANIA

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: 3/30/2025

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