NPIMap

Organization Active NPI

Montgomery County MH-Mr Emergency Service

  • Psychiatric Hospital
  • Norristown, PA
National Provider Identifier
1386637734
Registry record updated Aug 12, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric HospitalTaxonomy code 283Q00000X
License
173410 Issued in PA
Legal business name
MONTGOMERY COUNTY MH-MR EMERGENCY SERVICE
Practice address
50 Beech Dr
Norristown, PA 19403-5421
Phone
(610) 279-6100
Fax
(610) 279-0978
NPI assigned
Aug 31, 2005
Last updated
Aug 12, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2010

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

Authorized official

Name
Deborah Shanley
Title
Administrative Assistant
Phone
(610) 279-6100

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital 283Q00000X 173410 PA Primary
Ambulance 341600000X 03261 PA

Addresses

Primary practice location

50 Beech Dr
Norristown, PA 19403-5421

Mailing address

50 Beech Dr
Norristown, PA 19403-5421
Phone (610) 279-6100

Other identifiers 4

IdentifierTypeStateIssuer
1373OtherPAAETNA
48810OtherPAKEYSTONE MERCY
100756802MedicaidPA
1158OtherPABLUE CROSS

Other names 1

  • Montgomery County Emergency Service, Inc. Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20040121000644 PA Part B Supplier - Clinic/Group Practice 3274435268 Receives reassigned benefits from 27 practitioners
Practice locations: Norristown, PA
O20100929000266 PA Part A Provider - Hospital 3274435268 Practice locations: Norristown, PA
O20130418000095 PA Part B Supplier - Ambulance Service Supplier 3274435268 Practice locations: Norristown, PA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1386637734. Details of each certification follow.

Hospital certification: CCN 394033

Legal name
MONTGOMERY COUNTY MH-MR EMERGENCY SERVICE
Doing business as
MONTGOMERY COUNTY EMERGENCY SERVICE
Certification status
Active
Provider type (POS)
Hospital – Psychiatric
Participating since
Feb 21, 1975
Last certification
Dec 23, 2015
Beds
73
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
Sep 2, 1971 in PA
Enrollment address
50 Beech Drive
Montgomery County MH-Mr Emergency Service
Norristown, PA 19403-5421
Other Hospital Practice Location
Hospital subgroups
Psychiatric

Care Compare: Hospital

Medicare Care Compare
Listed as
Montgomery County Emergency ServiceCCN 394033 · All quality measures
Type
Psychiatric
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
No

National Provider Directory

National Provider Directory

Locations

50 Beech Dr
Norristown, PA 19403
Phone (610) 279-6100

Ownership & related parties

All disclosed owners & managing parties 9

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Douglas Hager Individual Corporate DirectorBoard Member Sep 24, 2014
William Myers Individual Corporate OfficerCeo Jul 1, 2016
W-2 Managing EmployeeCeo Jul 1, 2016
Randall Floyd Individual Corporate DirectorBoard Member May 26, 2010
Faith Millen Individual Corporate DirectorBoard Member Jun 24, 2009
Michael Kennedy Individual Corporate OfficerBoard President Jun 25, 2014
Corporate DirectorBoard Member Dec 2, 2009
Caroline Ellison Individual Corporate OfficerBoard VP Jun 27, 2012
Corporate DirectorBoard Member Aug 1, 2007
Logan Wilson-Brown Individual Corporate DirectorBoard Member Jan 27, 2021
Barbara Rawls Individual Corporate OfficerTreasurer Jun 23, 2021
Corporate DirectorBoard Member Jun 24, 2009
Mary Turner Individual Corporate Director Jun 26, 2019

Practitioners & affiliated clinicians

Practitioners 29

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.

View all 29

NPI Registry JSON

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

{
    "created_epoch": "1125446400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1281571200000",
    "number": "1386637734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 BEECH DR",
            "city": "NORRISTOWN",
            "state": "PA",
            "postal_code": "194035421",
            "telephone_number": "610-279-6100",
            "fax_number": "610-279-0978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 BEECH DR",
            "city": "NORRISTOWN",
            "state": "PA",
            "postal_code": "194035421",
            "telephone_number": "610-279-6100",
            "fax_number": "610-279-0978"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONTGOMERY COUNTY MH-MR EMERGENCY SERVICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-31",
        "last_updated": "2010-08-12",
        "status": "A",
        "authorized_official_last_name": "SHANLEY",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_title_or_position": "ADMINISTRATIVE ASSISTANT",
        "authorized_official_telephone_number": "610-279-6100"
    },
    "taxonomies": [
        {
            "code": "283Q00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Hospital",
            "state": "PA",
            "license": "173410",
            "primary": true
        },
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "PA",
            "license": "03261",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "1373",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE MERCY",
            "identifier": "48810",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100756802",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "1158",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Montgomery County Emergency Service, Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Norristown, PA

Sources for this page

Verify at the official NPI Registry.