NPIMap

Organization Active NPI

Phoenixville Clinic Company LLC

Doing business as Phoenixville Family & Sports Medicine

  • Sports Medicine (Family Medicine) Physician
  • Phoenixville, PA
National Provider Identifier
1720018898
Registry record updated Mar 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
Legal business name
PHOENIXVILLE CLINIC COMPANY LLC
Doing business as
Phoenixville Family & Sports Medicine
Practice address
300 Schuylkill Rd
Phoenixville, PA 19460
Phone
(610) 933-0294
NPI assigned
Jul 4, 2006
Last updated
Mar 26, 2019By the provider in NPPES
Organization subpart
Yes
Parent organization
PHOENIXVILLE CLINIC COMPANY LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 26, 2019

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

Authorized official

Name
Gary Conner
Title
VP & Cfo
Phone
(484) 628-8181

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Family Medicine) Physician 207QS0010X NU Primary
Obstetrics & Gynecology Physician 207V00000X NU

Addresses

Primary practice location

300 Schuylkill Rd
Phoenixville, PA 19460

Mailing address

PO Box 13579
Reading, PA 19612-3579

Other names 1

  • Phoenixville Family & Sports Medicine Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Phoenixville Clinic Company LLC3 organizations share this tax ID, including this one
Part of
Phoenixville Clinic Company LLC

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": "1151971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1553558400000",
    "number": "1720018898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13579",
            "city": "READING",
            "state": "PA",
            "postal_code": "196123579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 SCHUYLKILL RD",
            "city": "PHOENIXVILLE",
            "state": "PA",
            "postal_code": "19460",
            "telephone_number": "610-933-0294"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIXVILLE CLINIC COMPANY LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PHOENIXVILLE CLINIC COMPANY LLC",
        "enumeration_date": "2006-07-04",
        "last_updated": "2019-03-26",
        "status": "A",
        "authorized_official_last_name": "CONNER",
        "authorized_official_first_name": "GARY",
        "authorized_official_title_or_position": "VP & CFO",
        "authorized_official_telephone_number": "484-628-8181"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Phoenixville Family & Sports Medicine",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Phoenixville Family & Sports Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Phoenixville, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2019; 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.