NPIMap

Organization Active NPI

Clinical Care Associates of the University of Pennsylvania Health

  • Psychologist
  • West Chester, PA
National Provider Identifier
1649940107
Registry record updated Sep 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
CLINICAL CARE ASSOCIATES OF THE UNIVERSITY OF PENNSYLVANIA HEALTH
Practice address
701 E Marshall St
West Chester, PA 19380-4412
Phone
(610) 431-5000
NPI assigned
Sep 16, 2021
Last updated
Sep 16, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2021

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

Authorized official

Name
Chante L Jackson
Title
Payer Supervisor
Phone
(215) 662-6187

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X Primary

Addresses

Primary practice location

701 E Marshall St
West Chester, PA 19380-4412

Mailing address

701 E Marshall St
West Chester, PA 19380-4412

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031113000301 PA Part B Supplier - Clinic/Group Practice 4688588866 Receives reassigned benefits from 1,081 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment

Other NPIs on the same Medicare enrollment 6

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

National Provider Directory

National Provider Directory
Tax ID family
Penncare-Pennsylvania Hospitalist Associates13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

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

Locations

191 Presidential Blvd
Ste C133
Bala Cynwyd, PA 19004
Phone (484) 883-6984

191 Presidential Blvd
Ste C135
Bala Cynwyd, PA 19004
Phone (484) 270-1904

333 E City Ave
Ste IL27
Bala Cynwyd, PA 19004
Phone (610) 664-5156

1001 Chesterbrook Blvd
Berwyn, PA 19312
Phone (610) 576-7500

402 Hyde Park
Doylestown, PA 18902
Phone (215) 489-9300

728 W Lincoln Hwy
Fl 2
Exton, PA 19341
Phone (610) 423-4556

420 W Township Line Rd
Havertown, PA 19083
Phone (215) 624-7201

2200 Renaissance Blvd
Ste 320
King of Prussia, PA 19406
Phone (610) 239-2740

1530 Woodbourne Rd
Levittown, PA 19057
Phone (215) 945-1650

23 Bishop Hollow Rd
Newtown Square, PA 19073
Phone (610) 353-9100

230 W Washington Sq
Philadelphia, PA 19106
Phone (215) 829-6088

441 Lyceum Ave
Philadelphia, PA 19128
Phone (215) 483-2133

4623 Spruce St
Philadelphia, PA 19139
Phone (215) 474-6100

601 Walnut St W
Philadelphia, PA 19106
Phone (215) 629-1866

7133 Roosevelt Blvd
Philadelphia, PA 19149
Phone (215) 333-3311

727 Delancey St
Philadelphia, PA 19106
Phone (215) 572-5200

727 Delancey St
Ste 1A
Philadelphia, PA 19106
Phone (215) 829-3016

444 Valley Forge Rd
Phoenixville, PA 19460
Phone (610) 482-2528

824 Main St
Ste 100A
Phoenixville, PA 19460
Phone (610) 917-0320

130 S State Rd
Ste 106
Springfield, PA 19064
Phone (610) 690-5110

105 Vineyard Way
Ste 102
West Grove, PA 19390
Phone (610) 903-6200

Practitioners & affiliated clinicians

Practitioners 946

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.

View all 946

NPI Registry JSON

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

{
    "created_epoch": "1631750400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1631750400000",
    "number": "1649940107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 E MARSHALL ST",
            "city": "WEST CHESTER",
            "state": "PA",
            "postal_code": "193804412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 E MARSHALL ST",
            "city": "WEST CHESTER",
            "state": "PA",
            "postal_code": "193804412",
            "telephone_number": "610-431-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINICAL CARE ASSOCIATES OF THE UNIVERSITY OF PENNSYLVANIA HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-16",
        "last_updated": "2021-09-16",
        "certification_date": "2021-09-16",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "CHANTE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PAYER SUPERVISOR",
        "authorized_official_telephone_number": "215-662-6187"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Chester, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2021; 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.