Prospect CCMC, LLC

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

PROSPECT CCMC, LLC

Practice address

200 W Sproul Rd
Springfield, PA 19064-2016

Phone

(610) 284-0700

NPI assigned

Mar 17, 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

Locations

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

{
    "created_epoch": "1458172800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1610668800000",
    "number": "1215398276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 W SPROUL RD",
            "city": "SPRINGFIELD",
            "state": "PA",
            "postal_code": "190642016",
            "telephone_number": "610-284-0700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 W SPROUL RD",
            "city": "SPRINGFIELD",
            "state": "PA",
            "postal_code": "190642016",
            "telephone_number": "610-284-0700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROSPECT CCMC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-17",
        "last_updated": "2021-01-15",
        "certification_date": "2021-01-15",
        "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": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 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.