POTTSTOWN CLINIC COMPANY LLC - NPI NUMBER 1649341934

Summary

Provider Name: POTTSTOWN CLINIC COMPANY LLC

NPI Number: 1649341934

Clasification: Hospitalist (208M00000X)

Address:
730 S HANOVER ST
POTTSTOWN, PA
ZIP 19465

Phone Number: (610) 323-6835



Detailed Information

POTTSTOWN CLINIC COMPANY LLC is a hospitalist in Pottstown, PA. The provider is hospitalists are physicians whose primary professional focus is the general medical care of hospitalized patients. Their activities include patient care, teaching, research, and leadership related to Hospital Medicine. The term 'hospitalist' refers to physicians whose practice emphasizes providing care for hospitalized patients. The assigned NPI number for this provider is 1649341934 and is registered as an organization entity type and is a multi-specialty group.

The provider's business address is:

730 S HANOVER ST
POTTSTOWN, PA
ZIP 19465-520
Phone: (610) 323-6835

The provider's authorized official is Sophia L Arwood .
The authorized official title is Director and has the following contact phone number (615) 628-6038.

The enumeration date for this NPI number is 11/10/2006 and was last updated on 2/26/2015.

Map - Location of Practice

Similar Providers

NPI Provider Name / Taxonomy
1124203633 RACHEL ERYN BAGELMAN, MD
Hospitalist
1669442885 NOAH A BASS, DO
Hospitalist





Taxonomy Codes

The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1 208M00000X Hospitalist No
2 207R00000X Internal Medicine No
3 208600000X Surgery No
4 207ZH0000X Pathology Hematology No
5 207P00000X Emergency Medicine No
6 363L00000X Nurse Practitioner No
7 2084N0400X Psychiatry & Neurology Neurology No
8 2085R0202X Radiology Diagnostic Radiology No
9 2085N0904X Radiology Nuclear Radiology No
10 2085R0204X Radiology Vascular & Interventional Radiology No
11 207ZP0101X Pathology Anatomic Pathology No
12 208VP0000X Pain Medicine Pain Medicine No
13 208000000X Pediatrics No
14 225100000X Physical Therapist No
15 207Q00000X Family Medicine Yes

Other (Legacy) Identifiers

The following legacy identifiers are available for this provider:

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1 106692 MEDICARE PIN PA
2 101814268 0008 MEDICAID PA

NPI Record

No. Field Name Field Value Field Definition 1
1 NPI 1649341934 The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
2 Entity Type Code 2 Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
3 Employer Identification Number EIN The Employer Identification Number (EIN), assigned by the IRS, of the provider being identified.
4 Provider Organization Name Legal Business Name POTTSTOWN CLINIC COMPANY LLC The name of the organization provider. If the provider is an organization, this is the legal business name.
5 Provider First Line Business Practice Location Address 730 S HANOVER ST The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
6 Provider Business Practice Location Address City Name POTTSTOWN The city name in the location address of the provider being identified.
7 Provider Business Practice Location Address State Name PA The State code in the location of the provider being identified.
8 Provider Business Practice Location Address Postal Code 194657520 The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
9 Provider Business Practice Location Address Country Code If outside U S US The country code in the location address of the provider being identified.
10 Provider Business Practice Location Address Telephone Number 6103236835 The telephone number associated with the location address of the provider being identified.
11 Provider Enumeration Date 11/10/2006 The date the provider was assigned a unique identifier (assigned an NPI).
12 Last Update Date 2/26/2015 The date that a record was last updated or changed.
13 Authorized Official Last Name ARWOOD The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
14 Authorized Official First Name SOPHIA The first name of the authorized official.
15 Authorized Official Middle Name L The middle name of the authorized official.
16 Authorized Official Title or Position DIRECTOR The title or position of the authorized official.
17 Authorized Official Telephone Number 6156286038 The 10-position telephone number of the authorized official.
18 Healthcare Provider Taxonomy Code 1 208M00000X Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
19 Healthcare Provider Primary Taxonomy Switch 1 N
20 Healthcare Provider Taxonomy Code 2 207R00000X
21 Healthcare Provider Primary Taxonomy Switch 2 N
22 Healthcare Provider Taxonomy Code 3 208600000X
23 Healthcare Provider Primary Taxonomy Switch 3 N
24 Healthcare Provider Taxonomy Code 4 207ZH0000X
25 Healthcare Provider Primary Taxonomy Switch 4 N
26 Healthcare Provider Taxonomy Code 5 207P00000X
27 Healthcare Provider Primary Taxonomy Switch 5 N
28 Healthcare Provider Taxonomy Code 6 363L00000X
29 Healthcare Provider Primary Taxonomy Switch 6 N
30 Healthcare Provider Taxonomy Code 7 2084N0400X
31 Healthcare Provider Primary Taxonomy Switch 7 N
32 Healthcare Provider Taxonomy Code 8 2085R0202X
33 Healthcare Provider Primary Taxonomy Switch 8 N
34 Healthcare Provider Taxonomy Code 9 2085N0904X
35 Healthcare Provider Primary Taxonomy Switch 9 N
36 Healthcare Provider Taxonomy Code 10 2085R0204X
37 Healthcare Provider Primary Taxonomy Switch 10 N
38 Healthcare Provider Taxonomy Code 11 207ZP0101X
39 Healthcare Provider Primary Taxonomy Switch 11 N
40 Healthcare Provider Taxonomy Code 12 208VP0000X
41 Healthcare Provider Primary Taxonomy Switch 12 N
42 Healthcare Provider Taxonomy Code 13 208000000X
43 Healthcare Provider Primary Taxonomy Switch 13 N
44 Healthcare Provider Taxonomy Code 14 225100000X
45 Healthcare Provider Primary Taxonomy Switch 14 N
46 Healthcare Provider Taxonomy Code 15 207Q00000X
47 Healthcare Provider Primary Taxonomy Switch 15 Y
48 Other Provider Identifier 1 106692 Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
49 Other Provider Identifier Type Code 1 08 Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
50 Other Provider Identifier State 1 PA
51 Other Provider Identifier 2 101814268 0008 Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
52 Other Provider Identifier Type Code 2 05 Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
53 Other Provider Identifier State 2 PA
54 Is Organization Subpart N
55 Healthcare Provider Taxonomy Group 1 193200000X MULTI-SPECIALTY GROUP
56 Healthcare Provider Taxonomy Group 2 193200000X MULTI-SPECIALTY GROUP
57 Healthcare Provider Taxonomy Group 3 193200000X MULTI-SPECIALTY GROUP
58 Healthcare Provider Taxonomy Group 4 193200000X MULTI-SPECIALTY GROUP
59 Healthcare Provider Taxonomy Group 5 193200000X MULTI-SPECIALTY GROUP
60 Healthcare Provider Taxonomy Group 6 193200000X MULTI-SPECIALTY GROUP
61 Healthcare Provider Taxonomy Group 7 193200000X MULTI-SPECIALTY GROUP
62 Healthcare Provider Taxonomy Group 8 193200000X MULTI-SPECIALTY GROUP
63 Healthcare Provider Taxonomy Group 9 193200000X MULTI-SPECIALTY GROUP
64 Healthcare Provider Taxonomy Group 10 193200000X MULTI-SPECIALTY GROUP
65 Healthcare Provider Taxonomy Group 11 193200000X MULTI-SPECIALTY GROUP
66 Healthcare Provider Taxonomy Group 12 193200000X MULTI-SPECIALTY GROUP
67 Healthcare Provider Taxonomy Group 13 193200000X MULTI-SPECIALTY GROUP
68 Healthcare Provider Taxonomy Group 14 193200000X MULTI-SPECIALTY GROUP
69 Healthcare Provider Taxonomy Group 15 193200000X MULTI-SPECIALTY GROUP

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This page was last updated on: 3/10/2015

(1) Field Definition Source-. Federal Register / Vol. 69, No. 15 / Friday, January 23, 2004 / Rules and Regulations - Part II Department of Health and Human Services Office of the Secretary 45 CFR Part 162 HIPAA Administrative Simplification: Standard Unique Health Identifier for Health Care Providers; Final Rule

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