NPIMap

Organization Active NPI

Gaudenzia Inc

  • Clinic/Center
  • Pottsville, PA
National Provider Identifier
1104058338
Registry record updated Feb 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
547027 Issued in PA
Legal business name
GAUDENZIA INC
Practice address
1 S 2ND St
4TH Floor
Pottsville, PA 17901-3174
Phone
(570) 622-6485
Fax
(570) 622-2422
NPI assigned
Aug 21, 2009
Last updated
Feb 24, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2022

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

Authorized official

Name
Mike Williams
Title
Sr. Contracting Manager
Phone
(484) 338-3731

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 547027 PA Primary

Addresses

Primary practice location

1 S 2ND St
4TH Floor
Pottsville, PA 17901-3174

Mailing address

106 W Main St
Norristown, PA 19401-4716
Phone (610) 239-9600

Other names 1

  • GAUDENZIA POTTSVILLE OUTPATIENT Other name

National Provider Directory

National Provider Directory
Tax ID family
Gaudenziaorg77 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 17

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

View all 17

Locations

1 S 2nd St
Fl 4
Pottsville, PA 17901
Phone (570) 622-6485

NPI Registry JSON

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

{
    "created_epoch": "1250812800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1645660800000",
    "number": "1104058338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 W MAIN ST",
            "city": "NORRISTOWN",
            "state": "PA",
            "postal_code": "194014716",
            "telephone_number": "610-239-9600",
            "fax_number": "610-275-7025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 S 2ND ST",
            "address_2": "4TH FLOOR",
            "city": "POTTSVILLE",
            "state": "PA",
            "postal_code": "179013174",
            "telephone_number": "570-622-6485",
            "fax_number": "570-622-2422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GAUDENZIA INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-21",
        "last_updated": "2022-02-24",
        "certification_date": "2022-02-24",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "MIKE",
        "authorized_official_title_or_position": "SR. CONTRACTING MANAGER",
        "authorized_official_telephone_number": "484-338-3731"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "PA",
            "license": "547027",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GAUDENZIA POTTSVILLE OUTPATIENT",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "GAUDENZIA POTTSVILLE OUTPATIENT",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Pottsville, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 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.