NPIMap

Organization Active NPI

Prostat, Inc.

  • Early Intervention Provider Agency
  • Reading, PA
National Provider Identifier
1780018424
Registry record updated Aug 27, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Early Intervention Provider AgencyTaxonomy code 252Y00000X
Legal business name
PROSTAT, INC.
Practice address
1901 Bernville Rd
Reading, PA 19601-1113
Phone
(610) 736-9000
NPI assigned
Aug 29, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2014

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

Authorized official

Name
Marissa Marie Shelly, M.S. CCC-SLP
Title
Speech Language Pathologist
Phone
(610) 736-9000

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Early Intervention Provider Agency 252Y00000X Primary
Non-emergency Medical Transport (VAN) 343900000X
Private Vehicle 347C00000X

Addresses

Primary practice location

1901 Bernville Rd
Reading, PA 19601-1113

Mailing address

1901 Bernville Rd
Reading, PA 19601-1113
Phone (610) 736-9000

Other identifiers 4

IdentifierTypeStateIssuer
343800000XMedicaidPA
1024232050001MedicaidPA
1024232050002MedicaidPA
1024232050003MedicaidPA

National Provider Directory

National Provider Directory
Tax ID family
Prostat Inc4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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": "1377734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1409097600000",
    "number": "1780018424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901 BERNVILLE RD",
            "city": "READING",
            "state": "PA",
            "postal_code": "196011113",
            "telephone_number": "610-736-9000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 BERNVILLE RD",
            "city": "READING",
            "state": "PA",
            "postal_code": "196011113",
            "telephone_number": "610-736-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROSTAT, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-29",
        "last_updated": "2014-08-27",
        "status": "A",
        "authorized_official_last_name": "SHELLY",
        "authorized_official_first_name": "MARISSA",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "SPEECH LANGUAGE PATHOLOGIST",
        "authorized_official_telephone_number": "610-736-9000",
        "authorized_official_credential": "M.S. CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "347C00000X",
            "taxonomy_group": "",
            "desc": "Private Vehicle",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "343800000X",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1024232050001",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1024232050002",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1024232050003",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Reading, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2014; 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.