NPIMap

Organization Active NPI

Commonwealth Clinical Group, Inc.

  • Community/Behavioral Health Agency
  • Exton, PA
National Provider Identifier
1750706198
Registry record updated Sep 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
326900 Issued in PA
Legal business name
COMMONWEALTH CLINICAL GROUP, INC.
Practice address
479 Thomas Jones Way
Suite 100
Exton, PA 19341-2580
Phone
(484) 879-6751
Fax
(484) 879-6759
NPI assigned
Feb 21, 2014
Last updated
Sep 15, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2021

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

Authorized official

Name
Stacie Basham
Title
Billing Coordinator
Phone
(717) 393-3900

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 326900 PA Primary

Addresses

Primary practice location

479 Thomas Jones Way
Suite 100
Exton, PA 19341-2580

Mailing address

41 E Orange St
Lancaster, PA 17602-2846
Phone (717) 393-3900

Other identifiers 1

IdentifierTypeStateIssuer
102233443MedicaidPA

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL central.referral@ccgtherapy.com

National Provider Directory

National Provider Directory
Tax ID family
Commonwealth Clinical Group Inc10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

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

Locations

479 Thomas Jones Way
Ste 100
Exton, PA 19341
Phone (484) 879-6751

36 E King St
Lancaster, PA 17602
Phone (717) 393-3900

NPI Registry JSON

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

{
    "created_epoch": "1392940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1631664000000",
    "number": "1750706198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41 E ORANGE ST",
            "city": "LANCASTER",
            "state": "PA",
            "postal_code": "176022846",
            "telephone_number": "717-393-3900",
            "fax_number": "717-393-7900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "479 THOMAS JONES WAY",
            "address_2": "SUITE 100",
            "city": "EXTON",
            "state": "PA",
            "postal_code": "193412580",
            "telephone_number": "484-879-6751",
            "fax_number": "484-879-6759"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMONWEALTH CLINICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-21",
        "last_updated": "2021-09-15",
        "certification_date": "2021-09-15",
        "status": "A",
        "authorized_official_last_name": "BASHAM",
        "authorized_official_first_name": "STACIE",
        "authorized_official_title_or_position": "BILLING COORDINATOR",
        "authorized_official_telephone_number": "717-393-3900"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "PA",
            "license": "326900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102233443",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "central.referral@ccgtherapy.com",
            "affiliation": "N",
            "address_1": "479 Thomas Jones Way",
            "address_2": "Suite 100",
            "city": "Exton",
            "state": "PA",
            "country_code": "US",
            "postal_code": "193412580",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Exton, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2021; 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.