McClatchy Avondale Corporation

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

023402 Issued in PA

Legal business name

MCCLATCHY AVONDALE CORPORATION

Practice address

773 E Haverford Rd
Bryn Mawr, PA 19010-3837

Phone

(610) 525-8300

Fax

(610) 519-0796

NPI assigned

Sep 20, 2005

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Michael McClatchy

Title

Administrator

Phone

(610) 525-8300

Specialties & licenses 2

Addresses

Other identifiers 3

Other names 1

• Bryn Mawr Terrace Convalscent Center Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1127174400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1200614400000",
    "number": "1013902667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "773 E HAVERFORD RD",
            "city": "BRYN MAWR",
            "state": "PA",
            "postal_code": "190103837",
            "telephone_number": "610-525-8300",
            "fax_number": "610-519-0796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "773 E HAVERFORD RD",
            "city": "BRYN MAWR",
            "state": "PA",
            "postal_code": "190103837",
            "telephone_number": "610-525-8300",
            "fax_number": "610-519-0796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCCLATCHY AVONDALE CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-20",
        "last_updated": "2008-01-18",
        "status": "A",
        "authorized_official_last_name": "MCCLATCHY",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "610-525-8300",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "PA",
            "license": "123050",
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "PA",
            "license": "023402",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA USHC",
            "identifier": "0116091",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "395095",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IBC",
            "identifier": "0005902000",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bryn Mawr Terrace Convalscent Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kim Mayhew, PA-C
• Patricia Martin Mayro, M.A.
• David Mazor, DMD
• Jennifer McBride, MSW
• Harriet Marie McCarney, CRNP
• Donald Allison McCown, M.S.S.. L.S.W.
• Tina Marie McCune, CRNP
• Kayla Siobhan McDaid, PA-C
• David E McGinnis, M.D.
• Angela M McGovern, MD

• Skilled Nursing Facility in Bryn Mawr, PA
• Providers in Bryn Mawr, PA by specialty
• Skilled Nursing Facility in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.