NPIMap

Organization Active NPI

Devereux Foundation Whitlock

  • Developmental Disabilities Clinic/Center
  • Berwyn, PA
National Provider Identifier
1609908375
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental Disabilities Clinic/CenterTaxonomy code 261QD1600X
License
104270 Issued in PA
Legal business name
DEVEREUX FOUNDATION WHITLOCK
Practice address
121 Leopard Rd
Berwyn, PA 19312-1809
Phone
(610) 296-6800
Fax
(610) 251-2013
NPI assigned
Mar 9, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Fran Wagner
Title
National Director, Accts Receivable
Phone
(610) 542-3084

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental Disabilities Clinic/Center 261QD1600X 104270 PA Primary
Developmental Disabilities Clinic/Center 261QD1600X 123180 PA

Addresses

Primary practice location

121 Leopard Rd
Berwyn, PA 19312-1809

Mailing address

2012 Renaissance Blvd
King of Prussia, PA 19406-2786
Phone (610) 542-3084

Other names 1

  • Whitlock Vocational Services Other name

National Provider Directory

National Provider Directory
Tax ID family
Community Services of Devereux333 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

121 Leopard Rd
Berwyn, PA 19312
Phone (610) 296-6800

NPI Registry JSON

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

{
    "created_epoch": "1173398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1609908375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2012 RENAISSANCE BLVD",
            "city": "KING OF PRUSSIA",
            "state": "PA",
            "postal_code": "194062786",
            "telephone_number": "610-542-3084",
            "fax_number": "610-542-3191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 LEOPARD RD",
            "city": "BERWYN",
            "state": "PA",
            "postal_code": "193121809",
            "telephone_number": "610-296-6800",
            "fax_number": "610-251-2013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEVEREUX FOUNDATION WHITLOCK",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WAGNER",
        "authorized_official_first_name": "FRAN",
        "authorized_official_title_or_position": "NATIONAL DIRECTOR, ACCTS RECEIVABLE",
        "authorized_official_telephone_number": "610-542-3084"
    },
    "taxonomies": [
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": "PA",
            "license": "104270",
            "primary": true
        },
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": "PA",
            "license": "123180",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Whitlock Vocational Services",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Berwyn, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.