Constitution Health LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

CONSTITUTION HEALTH LLC

Practice address

1215 Cedar Grove Rd
Media, PA 19063-1044

Phone

(610) 574-3978

NPI assigned

Feb 17, 2020

Organization subpart

No

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

Authorized official

Name

Holly Gleeson Schrock

Title

Managing Partner

Phone

(610) 574-3978

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1581897600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1583107200000",
    "number": "1982237145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1215 CEDAR GROVE RD",
            "city": "MEDIA",
            "state": "PA",
            "postal_code": "190631044",
            "telephone_number": "610-574-3978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 CEDAR GROVE RD",
            "city": "MEDIA",
            "state": "PA",
            "postal_code": "190631044",
            "telephone_number": "610-574-3978"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONSTITUTION HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-17",
        "last_updated": "2020-03-02",
        "certification_date": "2020-03-02",
        "status": "A",
        "authorized_official_last_name": "SCHROCK",
        "authorized_official_first_name": "HOLLY",
        "authorized_official_middle_name": "GLEESON",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "610-574-3978"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Media, PA
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• Family Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2020; 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.