NPIMap

Organization Active NPI

West Grove Clinic Company LLC

Doing business as Telemedicine Jennersville Tower Health Medical Group

  • Neurology Physician
  • West Grove, PA
National Provider Identifier
1093355992
Registry record updated Jan 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
Legal business name
WEST GROVE CLINIC COMPANY LLC
Doing business as
Telemedicine Jennersville Tower Health Medical Group
Practice address
1015 W Baltimore Pike
West Grove, PA 19390-9459
Phone
(610) 869-1555
NPI assigned
Jan 9, 2020
Last updated
Jan 14, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2020

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

Authorized official

Name
Gary Conner
Title
VP & Cfo
Phone
(484) 628-8181

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RI0200X
Neurology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084N0400X Primary
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X

Addresses

Primary practice location

1015 W Baltimore Pike
West Grove, PA 19390-9459

Mailing address

PO Box 13579
Reading, PA 19612-3579

Other names 1

  • Telemedicine Jennersville Tower Health Medical Group Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070129000812 PA Part B Supplier - Clinic/Group Practice 4789685033 Receives reassigned benefits from 113 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Kennett Square, PA; West Grove, PA

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

200 Old Forge Ln
Ste 202
Kennett Square, PA 19348
Phone (610) 388-1600

Practitioners & affiliated clinicians

Practitioners 113

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 113

NPI Registry JSON

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

{
    "created_epoch": "1578528000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1578960000000",
    "number": "1093355992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13579",
            "city": "READING",
            "state": "PA",
            "postal_code": "196123579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 W BALTIMORE PIKE",
            "city": "WEST GROVE",
            "state": "PA",
            "postal_code": "193909459",
            "telephone_number": "610-869-1555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST GROVE CLINIC COMPANY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-09",
        "last_updated": "2020-01-14",
        "certification_date": "2020-01-14",
        "status": "A",
        "authorized_official_last_name": "CONNER",
        "authorized_official_first_name": "GARY",
        "authorized_official_title_or_position": "VP & CFO",
        "authorized_official_telephone_number": "484-628-8181"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Infectious Disease",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Telemedicine Jennersville Tower Health Medical Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in West Grove, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.