LTC Aco Participant 102, PC

Primary specialty

Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X

Legal business name

LTC ACO PARTICIPANT 102, PC

Practice address

1700 Pine St
Norristown, PA 19401-3040

Phone

(610) 237-7100

Fax

(610) 277-6239

NPI assigned

Jan 29, 2026

Organization subpart

No

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

Authorized official

Name

Brittain Brantley

Title

Acting President

Phone

(302) 300-5138

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1769644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1786579200000",
    "number": "1851241988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 639676",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452639676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 PINE ST",
            "city": "NORRISTOWN",
            "state": "PA",
            "postal_code": "194013040",
            "telephone_number": "610-237-7100",
            "fax_number": "610-277-6239"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LTC ACO PARTICIPANT 102, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-01-29",
        "last_updated": "2026-08-13",
        "certification_date": "2026-08-13",
        "status": "A",
        "authorized_official_last_name": "BRANTLEY",
        "authorized_official_first_name": "BRITTAIN",
        "authorized_official_title_or_position": "ACTING PRESIDENT",
        "authorized_official_telephone_number": "302-300-5138"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Geriatric Medicine (Internal Medicine) Physician in Norristown, PA
• Providers in Norristown, PA by specialty
• Geriatric Medicine (Internal Medicine) Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2026; 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.