NPIMap

Organization Active NPI

Gaudenzia

  • Clinic/Center
  • West Chester, PA
National Provider Identifier
1881718062
Registry record updated May 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
157052 Issued in PA
Legal business name
GAUDENZIA
Practice address
110 Westtown Rd
Suite 115
West Chester, PA 19382-4978
Phone
(610) 429-1414
Fax
(610) 429-1833
NPI assigned
Mar 16, 2007
Last updated
May 8, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 8, 2021

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

Authorized official

Name
Mike Williams
Title
Sr. Contracting Manager
Phone
(484) 338-3731

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 157052 PA Primary

Addresses

Primary practice location

110 Westtown Rd
Suite 115
West Chester, PA 19382-4978

Mailing address

106 W Main St
Norristown, PA 19401-4716
Phone (610) 239-9600

Other identifiers 2

IdentifierTypeStateIssuer
1002285890063MedicaidPA
1002285890068MedicaidPA

Other names 1

  • GAUDENZIA WESTCHESTER OUTPATIENT Other name

National Provider Directory

National Provider Directory
Tax ID family
Gaudenzia77 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 18

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 18

Locations

110 Westtown Rd
Ste 115
West Chester, PA 19382
Phone (610) 429-1414

NPI Registry JSON

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

{
    "created_epoch": "1174003200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620432000000",
    "number": "1881718062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 W MAIN ST",
            "city": "NORRISTOWN",
            "state": "PA",
            "postal_code": "194014716",
            "telephone_number": "610-239-9600",
            "fax_number": "610-275-7025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 WESTTOWN RD",
            "address_2": "SUITE 115",
            "city": "WEST CHESTER",
            "state": "PA",
            "postal_code": "193824978",
            "telephone_number": "610-429-1414",
            "fax_number": "610-429-1833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GAUDENZIA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-16",
        "last_updated": "2021-05-08",
        "certification_date": "2021-05-08",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "MIKE",
        "authorized_official_title_or_position": "SR. CONTRACTING MANAGER",
        "authorized_official_telephone_number": "484-338-3731"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "PA",
            "license": "157052",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1002285890063",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1002285890068",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GAUDENZIA WESTCHESTER OUTPATIENT",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "GAUDENZIA WESTCHESTER OUTPATIENT",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in West Chester, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 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.