NPIMap

Organization Active NPI

Excela Practice Physicians Inc.

Doing business as Excela Health - Jeannette Quickcare

  • Non-Pharmacy Dispensing Site
  • Jeannette, PA
National Provider Identifier
1740506245
Registry record updated Oct 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-Pharmacy Dispensing SiteTaxonomy code 332900000X
License
OS005772L Issued in PA
Legal business name
EXCELA PRACTICE PHYSICIANS INC.
Doing business as
Excela Health - Jeannette Quickcare
Practice address
600 Jefferson Ave
Jeannette, PA 15644-2539
Phone
(724) 527-9375
NPI assigned
Apr 9, 2010
Last updated
Oct 23, 2012By the provider in NPPES
Organization subpart
Yes
Parent organization
MEDVANTX, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 23, 2012

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

Authorized official

Name
Kenny Heine
Title
Sr. Director of Operations
Phone
(858) 625-2990

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-Pharmacy Dispensing Site 332900000X OS005772L PA Primary

Addresses

Primary practice location

600 Jefferson Ave
Jeannette, PA 15644-2539

Mailing address

5626 Oberlin Dr
Suite 110
San Diego, CA 92121-1705

Other names 1

  • Excela Health - Jeannette Quickcare Doing business as

National Provider Directory

National Provider Directory
Tax ID family
West Primary HLTH Ctr D42 organizations share this tax ID, including this one
Part of
Medvantx Inc

Other organizations with this tax ID 41

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

View all 41

NPI Registry JSON

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

{
    "created_epoch": "1270771200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1350950400000",
    "number": "1740506245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5626 OBERLIN DR",
            "address_2": "SUITE 110",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921211705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 JEFFERSON AVE",
            "city": "JEANNETTE",
            "state": "PA",
            "postal_code": "156442539",
            "telephone_number": "724-527-9375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXCELA PRACTICE PHYSICIANS INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MEDVANTX, INC.",
        "enumeration_date": "2010-04-09",
        "last_updated": "2012-10-23",
        "status": "A",
        "authorized_official_last_name": "HEINE",
        "authorized_official_first_name": "KENNY",
        "authorized_official_title_or_position": "SR. DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "858-625-2990"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": "PA",
            "license": "OS005772L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Excela Health - Jeannette Quickcare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jeannette, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2012; 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.