NPIMap

Organization Active NPI

Scranton Quincy Clinic Company LLC

  • Neonatal-Perinatal Medicine Physician
  • Scranton, PA
National Provider Identifier
1619254026
Registry record updated Mar 22, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X
Legal business name
SCRANTON QUINCY CLINIC COMPANY LLC
Practice address
700 Quincy Ave
Scranton, PA 18510-1724
Phone
(570) 340-2552
Fax
(570) 340-2446
NPI assigned
Nov 14, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2012

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

Authorized official

Name
Debbie Thorn Brewer
Title
Director
Phone
(877) 892-9813

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal-Perinatal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2080N0001X Primary

Addresses

Primary practice location

700 Quincy Ave
Scranton, PA 18510-1724

Mailing address

PO Box 689022
Franklin, TN 37068-9022
Phone (877) 309-5312

Other identifiers 1

IdentifierTypeStateIssuer
102669377-0006MedicaidPA

Other names 1

  • Physicians Health Alliance Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120131000544 PA Part B Supplier - Clinic/Group Practice 0143487389 Receives reassigned benefits from 131 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Scranton, PA; Wilkes Barre, PA; Plains, PA; Pittston, PA; Old Forge, PA; Hollidaysburg, PA; Forty Fort, PA; Dunmore, PA…

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Physicians Health Alliance4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1321228800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1332374400000",
    "number": "1619254026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 689022",
            "city": "FRANKLIN",
            "state": "TN",
            "postal_code": "370689022",
            "telephone_number": "877-309-5312",
            "fax_number": "615-465-2877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 QUINCY AVE",
            "city": "SCRANTON",
            "state": "PA",
            "postal_code": "185101724",
            "telephone_number": "570-340-2552",
            "fax_number": "570-340-2446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SCRANTON QUINCY CLINIC COMPANY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-14",
        "last_updated": "2012-03-22",
        "status": "A",
        "authorized_official_last_name": "BREWER",
        "authorized_official_first_name": "DEBBIE",
        "authorized_official_middle_name": "THORN",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "877-892-9813"
    },
    "taxonomies": [
        {
            "code": "2080N0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102669377-0006",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Physicians Health Alliance",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Scranton, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.