Jennersville Radiology, P.C

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

Legal business name

JENNERSVILLE RADIOLOGY, P.C

Practice address

1015 W Baltimore Pike
West Grove, PA 19390-9459

Phone

(610) 372-4957

NPI assigned

Jul 21, 2005

Organization subpart

No

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

Authorized official

Name

Tracy Carmellini, M.D.

Title

Head Doctor

Phone

(610) 372-4957

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1121904000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1346240256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 MERIDIAN BLVD",
            "address_2": "2ND FLOOR",
            "city": "WYOMISSING",
            "state": "PA",
            "postal_code": "196103202",
            "telephone_number": "610-372-4957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 W BALTIMORE PIKE",
            "city": "WEST GROVE",
            "state": "PA",
            "postal_code": "193909459",
            "telephone_number": "610-372-4957"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JENNERSVILLE RADIOLOGY, P.C",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-21",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "CARMELLINI",
        "authorized_official_first_name": "TRACY",
        "authorized_official_title_or_position": "HEAD DOCTOR",
        "authorized_official_telephone_number": "610-372-4957",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "PA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0019412210001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennersville Hospital, LLC
• Jennersville Hospital, LLC
• Jennersville Hospital, LLC
• Jennersville Medical Associates, PC
• Jennersville Open MRI and Imaging Center, LLC
• Jennserville Obstetrics and Gynecology, LLC
• Jenny Chen Family Dentistry LLC
• Jennifer L Jines, DPT
• John H Plunkett DDS PC
• Alexandra Creighton Jones

• Diagnostic Radiology Physician in West Grove, PA
• Providers in West Grove, PA by specialty
• Diagnostic Radiology Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.