Prospect CCMC, LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

PROSPECT CCMC, LLC

Doing business as

New Pathways

Practice address

100 Crozerville Rd
Aston, PA 19014-1444

Phone

(610) 447-2000

Fax

(610) 447-6620

NPI assigned

Apr 12, 2016

Organization subpart

No

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

Authorized official

Name

Robert Jon Elders

Title

Secretary

Phone

(714) 788-1249

Specialties & licenses 1

Addresses

Other names 1

• New Pathways Doing business as

Locations

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

{
    "created_epoch": "1460419200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1610323200000",
    "number": "1043674351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 CROZERVILLE RD",
            "city": "ASTON",
            "state": "PA",
            "postal_code": "190141444",
            "telephone_number": "610-447-2000",
            "fax_number": "610-447-6620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 CROZERVILLE RD",
            "city": "ASTON",
            "state": "PA",
            "postal_code": "190141444",
            "telephone_number": "610-447-2000",
            "fax_number": "610-447-6620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROSPECT CCMC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-12",
        "last_updated": "2021-01-11",
        "certification_date": "2021-01-11",
        "status": "A",
        "authorized_official_last_name": "ELDERS",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "JON",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "714-788-1249"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "New Pathways",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Clinic/Center in Aston, PA
• Providers in Aston, PA by specialty
• Clinic/Center in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2021; 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.