NPIMap

Organization Active NPI

Gaudenzia Inc

  • Clinic/Center
  • Mechanicsburg, PA
National Provider Identifier
1386769545
Registry record updated Mar 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
211144 Issued in PA
Legal business name
GAUDENZIA INC
Practice address
4740 Delbrook Rd
Mechanicsburg, PA 17050-3041
Phone
(717) 766-8517
Fax
(717) 796-0196
NPI assigned
Mar 20, 2007
Last updated
Mar 10, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2022

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

Authorized official

Name
Mike Williams
Title
Sr. Contracting Manager
Phone
(484) 338-3731

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 211144 PA Primary

Addresses

Primary practice location

4740 Delbrook Rd
Mechanicsburg, PA 17050-3041

Mailing address

106 W Main St
Norristown, PA 19401-4716
Phone (610) 239-9600

Other identifiers 2

IdentifierTypeStateIssuer
1002285890084MedicaidPA
1002285890080MedicaidPA

Other names 1

  • GAUDENZIA WESTSHORE OUTPATIENT SERVICES Other name

National Provider Directory

National Provider Directory
Tax ID family
Gaudenzia77 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

4740 Delbrook Rd
Mechanicsburg, PA 17050
Phone (717) 761-6862

Practitioners & affiliated clinicians

Practitioners 1

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": "1174348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646870400000",
    "number": "1386769545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 W MAIN ST",
            "city": "NORRISTOWN",
            "state": "PA",
            "postal_code": "194014716",
            "telephone_number": "610-239-9600",
            "fax_number": "610-275-7025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4740 DELBROOK RD",
            "city": "MECHANICSBURG",
            "state": "PA",
            "postal_code": "170503041",
            "telephone_number": "717-766-8517",
            "fax_number": "717-796-0196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GAUDENZIA INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-20",
        "last_updated": "2022-03-10",
        "certification_date": "2022-03-10",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "MIKE",
        "authorized_official_title_or_position": "SR. CONTRACTING MANAGER",
        "authorized_official_telephone_number": "484-338-3731"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "PA",
            "license": "211144",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1002285890084",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1002285890080",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GAUDENZIA WESTSHORE OUTPATIENT SERVICES",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "GAUDENZIA WESTSHORE OUTPATIENT SERVICES",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Mechanicsburg, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 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.