Organization Active NPI

Bryn Mawr Skin & Cancer LLP

  • Specialist
  • Rosemont, PA
National Provider Identifier
1346205242
Registry record updated Mar 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
BRYN MAWR SKIN & CANCER LLP
Practice address
919 Conestoga Rd
BLDG 2, Suite 106
Rosemont, PA 19010
Phone
(610) 525-5025
Fax
(610) 525-2494
NPI assigned
Apr 20, 2006
Last updated
Mar 12, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2015

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

Authorized official

Name
Teri V Campbell, CMM
Title
Practice Administrator
Phone
(610) 525-5028

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X Primary

Addresses

Primary practice location

919 Conestoga Rd
BLDG 2, Suite 106
Rosemont, PA 19010

Mailing address

919 Conestoga Rd
BLDG 2, Suite 106
Bryn Mawr, PA 19010-1352
Phone (610) 525-5025

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040727000440 PA Part B Supplier - Clinic/Group Practice 8123098324 Receives reassigned benefits from 11 practitioners
Practice locations: Bryn Mawr, PA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
39D0195109Bryn Mawr Skin and Cancer Institute919 Conestoga Road Suite 106 BLDG 2, Bryn Mawr, PA 19010ComplianceJan 17, 2027

National Provider Directory

National Provider Directory

Locations

830 Old Lancaster Rd
Ste 108
Bryn Mawr, PA 19010
Phone (610) 520-5200

919 Conestoga Rd
Ste 106
Bryn Mawr, PA 19010
Phone (215) 525-5028

919 Conestoga Rd
Ste 2-106
Bryn Mawr, PA 19010
Phone (610) 525-5028

Practitioners & affiliated clinicians

Practitioners 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1145491200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1426118400000",
    "number": "1346205242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "919 CONESTOGA RD",
            "address_2": "BLDG 2, SUITE 106",
            "city": "BRYN MAWR",
            "state": "PA",
            "postal_code": "190101352",
            "telephone_number": "610-525-5025",
            "fax_number": "610-525-2494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "919 CONESTOGA RD",
            "address_2": "BLDG 2, SUITE 106",
            "city": "ROSEMONT",
            "state": "PA",
            "postal_code": "19010",
            "telephone_number": "610-525-5025",
            "fax_number": "610-525-2494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRYN MAWR SKIN & CANCER LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-20",
        "last_updated": "2015-03-12",
        "status": "A",
        "authorized_official_last_name": "CAMPBELL",
        "authorized_official_first_name": "TERI",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "610-525-5028",
        "authorized_official_credential": "CMM"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rosemont, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.