NPIMap

Organization Active NPI

Pottstown Hospital Company LLC

Doing business as Coventry Medical Group - Peds

  • Pediatrics Physician
  • Pottstown, PA
National Provider Identifier
1881696664
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
POTTSTOWN HOSPITAL COMPANY LLC
Doing business as
Coventry Medical Group - Peds
Practice address
1610 Medical Dr
Pottstown, PA 19464-3292
Phone
(610) 326-8660
Fax
(610) 326-8408
NPI assigned
Aug 11, 2005
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Gary D Newsome
Title
President
Phone
(615) 373-9600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X PA Primary

Addresses

Primary practice location

1610 Medical Dr
Pottstown, PA 19464-3292

Mailing address

730 S Hanover St
Pottstown, PA 19465-7520
Phone (610) 323-6835

Other identifiers 1

IdentifierTypeStateIssuer
1007517440011MedicaidPA

Other names 1

  • Coventry Medical Group - Peds Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Pottstown Hospital Company LLC7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

Locations

1610 Medical Dr
Pottstown, PA 19464
Phone (610) 323-6835

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1123718400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1881696664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "730 S HANOVER ST",
            "city": "POTTSTOWN",
            "state": "PA",
            "postal_code": "194657520",
            "telephone_number": "610-323-6835",
            "fax_number": "610-323-4154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1610 MEDICAL DR",
            "city": "POTTSTOWN",
            "state": "PA",
            "postal_code": "194643292",
            "telephone_number": "610-326-8660",
            "fax_number": "610-326-8408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POTTSTOWN HOSPITAL COMPANY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-11",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "NEWSOME",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "615-373-9600"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007517440011",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Coventry Medical Group - Peds",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pottstown, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.