Organization Active NPI

Premier Urgent Care at Kennett Square, LLC

  • Urgent Care Clinic/Center
  • Philadelphia, PA
National Provider Identifier
1679084354
Registry record updated Oct 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
PREMIER URGENT CARE AT KENNETT SQUARE, LLC
Practice address
2231 Bryn Mawr Avenue
Philadelphia, PA 19131-2399
Phone
(215) 883-0800
Fax
(215) 364-6488
NPI assigned
Oct 20, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2017

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

Authorized official

Name
Edward Silverman, DO
Title
Owner
Phone
(610) 561-6400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X Primary

Addresses

Primary practice location

2231 Bryn Mawr Avenue
Philadelphia, PA 19131-2399

Mailing address

278 Eagleview Blvd
Exton, PA 19341-1157
Phone (610) 561-6400

Other identifiers 1

IdentifierTypeStateIssuer
1027657850001MedicaidPA

National Provider Directory

National Provider Directory
Tax ID family
Premier Urgent Care at Kennett Square LLC3 organizations share this tax ID, including this one

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": "1508457600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1508457600000",
    "number": "1679084354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "278 EAGLEVIEW BLVD",
            "city": "EXTON",
            "state": "PA",
            "postal_code": "193411157",
            "telephone_number": "610-561-6400",
            "fax_number": "610-561-6401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2231 BRYN MAWR AVENUE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191312399",
            "telephone_number": "215-883-0800",
            "fax_number": "215-364-6488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER URGENT CARE AT KENNETT SQUARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-20",
        "last_updated": "2017-10-20",
        "status": "A",
        "authorized_official_last_name": "SILVERMAN",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "610-561-6400",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1027657850001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2017; 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.