NPIMap

Organization Active NPI

Pottstown Clinic Company, LLC

  • Family Medicine Physician
  • Pottstown, PA
National Provider Identifier
1407923519
Registry record updated Jun 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
POTTSTOWN CLINIC COMPANY, LLC
Practice address
730 S Hanover St
Pottstown, PA 19465-7520
Phone
(610) 323-6835
Fax
(610) 323-4154
NPI assigned
Nov 30, 2006
Organization subpart
Yes
Parent organization
POTTSTOWN CLINIC COMPANY, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 21, 2018

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

Authorized official

Name
Debbie T Brewer
Title
Director of Provider Enrollment
Phone
(877) 892-9813

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X

Addresses

Primary practice location

730 S Hanover St
Pottstown, PA 19465-7520

Mailing address

730 S Hanover St
Pottstown, PA 19465-7520
Phone (610) 323-6835

National Provider Directory

National Provider Directory
Tax ID family
Pottstown Memorial Medical Center3 organizations share this tax ID, including this one
Part of
Pottstown Memorial Medical Center

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529539200000",
    "number": "1407923519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "730 S HANOVER ST",
            "city": "POTTSTOWN",
            "state": "PA",
            "postal_code": "194657520",
            "telephone_number": "610-323-6835",
            "fax_number": "610-323-4154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "730 S HANOVER ST",
            "city": "POTTSTOWN",
            "state": "PA",
            "postal_code": "194657520",
            "telephone_number": "610-323-6835",
            "fax_number": "610-323-4154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POTTSTOWN CLINIC COMPANY, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "POTTSTOWN CLINIC COMPANY, LLC",
        "enumeration_date": "2006-11-30",
        "last_updated": "2018-06-21",
        "status": "A",
        "authorized_official_last_name": "BREWER",
        "authorized_official_first_name": "DEBBIE",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "DIRECTOR OF PROVIDER ENROLLMENT",
        "authorized_official_telephone_number": "877-892-9813"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pottstown, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2018; 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.