NPIMap

Organization Active NPI

Primary Home Care

  • Adult Health Nurse Practitioner
  • Elkins Park, PA
National Provider Identifier
1124062658
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
SP008740 Issued in PA
Legal business name
PRIMARY HOME CARE
Practice address
8080 Old York Rd
Elkins Park, PA 19027-1421
Phone
(215) 635-3151
NPI assigned
Jun 15, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Jerry Driscoll, NP
Title
President
Phone
(215) 635-3151

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LA2200X SP008740 PA Primary

Addresses

Primary practice location

8080 Old York Rd
Elkins Park, PA 19027-1421

Mailing address

8080 Old York Rd
Elkins Park, PA 19027-1421

Other identifiers 1

IdentifierTypeStateIssuer
SP008740OtherPANP LICENCE

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1124062658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8080 OLD YORK RD",
            "city": "ELKINS PARK",
            "state": "PA",
            "postal_code": "190271421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8080 OLD YORK RD",
            "city": "ELKINS PARK",
            "state": "PA",
            "postal_code": "190271421",
            "telephone_number": "215-635-3151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMARY HOME CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DRISCOLL",
        "authorized_official_first_name": "JERRY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "215-635-3151",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "PA",
            "license": "SP008740",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NP LICENCE",
            "identifier": "SP008740",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elkins Park, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.