NPIMap

Organization Active NPI

Christiana Care Pennsylvania Inc

Doing business as CCHS Sports Medicine Practice PA

  • Sports Medicine (Family Medicine) Physician
  • Chadds Ford, PA
National Provider Identifier
1639918964
Registry record updated Aug 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
Legal business name
CHRISTIANA CARE PENNSYLVANIA INC
Doing business as
CCHS Sports Medicine Practice PA
Practice address
161 Wilmington W Chester Pike
Chadds Ford, PA 19317-9041
Phone
(302) 320-9440
NPI assigned
May 24, 2024
Last updated
Aug 20, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
CHRISTIANA CARE PENNSYLVANIA INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 20, 2024

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

Authorized official

Name
Robert W McMurray Jr.
Title
Cfo
Phone
(302) 623-7362

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Family Medicine) Physician 207QS0010X Primary
Pediatric Sports Medicine Physician 2080S0010X

Addresses

Primary practice location

161 Wilmington W Chester Pike
Chadds Ford, PA 19317-9041

Mailing address

4000 Nexus Dr Ste E3
Wilmington, DE 19803-3000
Phone (302) 623-7362

Other names 1

  • CCHS Sports Medicine Practice PA Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240918002420 PA Part B Supplier - Clinic/Group Practice 8921549973 Receives reassigned benefits from 217 practitioners
14 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Kennett Square, PA; West Grove, PA; Media, PA; Havertown, PA; Glen Mills, PA; Chadds Ford, PA; Broomall, PA

Other NPIs on the same Medicare enrollment 14

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

View all 14

National Provider Directory

National Provider Directory
Tax ID family
Christiana Care Pennsylvania Inc18 organizations share this tax ID, including this one
Part of
Christiana Care Pennsylvania Inc

Other organizations with this tax ID 17

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

View all 17

Locations

500 Evergreen Dr
Ste 14
Glen Mills, PA 19342

Practitioners & affiliated clinicians

Practitioners 11

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": "1716508800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724112000000",
    "number": "1639918964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 NEXUS DR STE E3",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198033000",
            "telephone_number": "302-623-7362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "161 WILMINGTON W CHESTER PIKE",
            "city": "CHADDS FORD",
            "state": "PA",
            "postal_code": "193179041",
            "telephone_number": "302-320-9440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHRISTIANA CARE PENNSYLVANIA INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CHRISTIANA CARE PENNSYLVANIA INC",
        "enumeration_date": "2024-05-24",
        "last_updated": "2024-08-20",
        "certification_date": "2024-08-20",
        "status": "A",
        "authorized_official_last_name": "MCMURRAY",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "302-623-7362",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2080S0010X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Sports Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CCHS Sports Medicine Practice PA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chadds Ford, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2024; 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.