NPIMap

Organization Active NPI

Elwyn of Pennsylvania and Delaware

  • Developmentally Disabled Services Day Training Agency
  • Elwyn, PA
National Provider Identifier
1093889412
Registry record updated Mar 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X
Legal business name
ELWYN OF PENNSYLVANIA AND DELAWARE
Practice address
111 Elwyn Rd
Elwyn, PA 19063-4622
Phone
(610) 891-2000
Fax
(610) 891-2648
NPI assigned
Nov 17, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2022

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

Authorized official

Name
Donna K Busch
Title
Payer Contract Specialist
Phone
(445) 206-3028

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmentally Disabled Services Day Training Agency 251C00000X Primary

Addresses

Primary practice location

111 Elwyn Rd
Elwyn, PA 19063-4622

Mailing address

111 Elwyn Rd
Elwyn, PA 19063-4622
Phone (610) 891-2000

Other identifiers 1

IdentifierTypeStateIssuer
1000021240001MedicaidPA

Other names 1

  • Elwyn CREW CRS & Day Program Other name

National Provider Directory

National Provider Directory
Tax ID family
Elwyn Medical Services61 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 15

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646697600000",
    "number": "1093889412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 ELWYN RD",
            "city": "ELWYN",
            "state": "PA",
            "postal_code": "190634622",
            "telephone_number": "610-891-2000",
            "fax_number": "610-891-2648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 ELWYN RD",
            "city": "ELWYN",
            "state": "PA",
            "postal_code": "190634622",
            "telephone_number": "610-891-2000",
            "fax_number": "610-891-2648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELWYN OF PENNSYLVANIA AND DELAWARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-17",
        "last_updated": "2022-03-08",
        "certification_date": "2022-03-08",
        "status": "A",
        "authorized_official_last_name": "BUSCH",
        "authorized_official_first_name": "DONNA",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PAYER CONTRACT SPECIALIST",
        "authorized_official_telephone_number": "445-206-3028"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1000021240001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Elwyn CREW CRS & Day Program",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Elwyn, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2022; 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.