Provident Charter School

Primary specialty

Local Education Agency (LEA)Taxonomy code 251300000X

Legal business name

PROVIDENT CHARTER SCHOOL

Practice address

1400 Troy Hill Rd
Pittsburgh, PA 15212-5124

Phone

(412) 709-5160

Fax

(412) 206-9923

NPI assigned

Mar 6, 2017

Organization subpart

No

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

Authorized official

Name

Mr. Brett Marcoux

Title

Principal/Ceo

Phone

(412) 709-5160

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Courtney Mike-Wilson, MS

  • Behavior Technician
  • Columbia, MD
  • NPI 1407503725
  NPD

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

{
    "created_epoch": "1488758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1488758400000",
    "number": "1710427034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 TROY HILL RD",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152125124",
            "telephone_number": "412-709-5160",
            "fax_number": "412-206-9923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 TROY HILL RD",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152125124",
            "telephone_number": "412-709-5160",
            "fax_number": "412-206-9923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDENT CHARTER SCHOOL",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-06",
        "last_updated": "2017-03-06",
        "status": "A",
        "authorized_official_last_name": "MARCOUX",
        "authorized_official_first_name": "BRETT",
        "authorized_official_title_or_position": "PRINCIPAL/CEO",
        "authorized_official_telephone_number": "412-709-5160",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251300000X",
            "taxonomy_group": "",
            "desc": "Local Education Agency (LEA)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Molly Proud, OD
• Andrew Prout, M.D.
• Emilie Vanderslice Prout, PA-C
• Provenance Counseling and Wellness, LLC
• Sarah Marie Providence, PHARMD
• Mariah Cheyenne Provins
• Kelley Lee Prowitt
• Dominique Prue, MD
• Kathryn Pruett
• Heather Prunty

• Local Education Agency (LEA) in Pittsburgh, PA
• Providers in Pittsburgh, PA by specialty
• Local Education Agency (LEA) in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 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.