Organization Active NPI

Scranton Clinic Company LLC

  • Family Medicine Physician
  • Scranton, PA
National Provider Identifier
1912206723
Registry record updated Aug 16, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
SCRANTON CLINIC COMPANY LLC
Practice address
746 Jefferson Ave
3Rd Floor
Scranton, PA 18510-1624
Phone
(570) 344-9457
Fax
(570) 343-3731
NPI assigned
Mar 18, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2011

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

Authorized official

Name
Debbie T Brewer
Title
Director
Phone
(877) 892-9813

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Pulmonary Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RP1001X
Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208600000X

Addresses

Primary practice location

746 Jefferson Ave
3Rd Floor
Scranton, PA 18510-1624

Mailing address

4000 Meridian Blvd
Franklin, TN 37067-6325
Phone (877) 892-9813

Other identifiers 1

IdentifierTypeStateIssuer
102578488 0001MedicaidPA

National Provider Directory

National Provider Directory

Locations

746 Jefferson Ave
Fl 3
Scranton, PA 18510
Phone (570) 230-0045

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1300406400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1313452800000",
    "number": "1912206723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 MERIDIAN BLVD",
            "city": "FRANKLIN",
            "state": "TN",
            "postal_code": "370676325",
            "telephone_number": "877-892-9813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "746 JEFFERSON AVE",
            "address_2": "3RD FLOOR",
            "city": "SCRANTON",
            "state": "PA",
            "postal_code": "185101624",
            "telephone_number": "570-344-9457",
            "fax_number": "570-343-3731"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SCRANTON CLINIC COMPANY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-18",
        "last_updated": "2011-08-16",
        "status": "A",
        "authorized_official_last_name": "BREWER",
        "authorized_official_first_name": "DEBBIE",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "877-892-9813"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102578488 0001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Scranton, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2011; 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.