SCHUYLKILL MEDICAL CENTER - SOUTH JACKSON STREET (NPI# 1487960530) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487960530 |
| Entity Type | Organization |
| Organization Name | SCHUYLKILL MEDICAL CENTER - SOUTH JACKSON STREET |
| Other Organization Name | SCHUYLKILL MEDICAL CENTER - SOUTH JACKSON STREET PHYSICIAN GROUP |
| Practice Address |
420 S Jackson St Pottsville PA 17901-3625 |
| Practice Telephone | 5706215000 |
| Practice Fax Number | 5706228221 |
| Mailing Telephone | 5706215000 |
| Mailing Fax Number | 5706228221 |
| Enumeration Date | 2010-08-27 |
| Last Update Date | 2010-08-27 |
| Authorized Official Name | MR. JOHN E SIMODEJKA (PRESIDENT & CHIEF EXEC. OFFICER) |
| Authorized Official Telephone | 6106215111 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0204X |
Radiology Specialization: Vascular & Interventional Radiology |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Schuylkill Medical Center - South Jackson Street Physician Group | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255823845 | Schuylkill Medical Center - South Jackson Street | Rehabilitation Unit | 700 E Norwegian St, Pottsville, PA 17901-2710 | 2018-05-31 |
| 1184116774 | Schuylkill Medical Center - South Jackson Street | Psychiatric Unit | 700 E Norwegian St, Pottsville, PA 17901-2710 | 2018-05-31 |
| 1629303961 | Schuylkill Medical Center - South Jackson Street | Skilled Nursing Facility | 420 S Jackson St, Pottsville, PA 17901-3625 | 2009-10-05 |
| 1982606802 | Schuylkill Medical Center - South Jackson Street | Psychiatry & Neurology | 420 S Jackson St, Pottsville, PA 17901-3625 | 2005-08-11 |
| Street Address |
420 S JACKSON ST |
| City | POTTSVILLE |
| State | PA |
| Zip Code | 17901-3625 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902804511 | Glen A Marino | Neuromusculoskeletal Medicine & OMM | 420 S Jackson St, Pottsville, PA 17901-3625 | 2005-07-08 |
| 1821617150 | Rebecca Verderame | Occupational Therapist | 420 S Jackson St, Pottsville, PA 17901-3625 | 2020-04-16 |
| 1396309357 | Kaila D Muser | Physician Assistant | 420 S Jackson St, Pottsville, PA 17901-3625 | 2019-04-25 |
| 1649748385 | Leeann Mcdermott | Registered Nurse | 420 S Jackson St, Pottsville, PA 17901-3625 | 2018-11-12 |
| 1760922769 | Amy Strauss | Nurse Practitioner | 420 S Jackson St, Pottsville, PA 17901-3625 | 2017-02-24 |
| 1235514845 | Pottsville Medical Services, LLC | Emergency Medicine | 420 S Jackson St, Pottsville, PA 17901-3625 | 2015-07-24 |
| 1730566498 | Ashlee Moore | Speech-Language Pathologist | 420 S Jackson St, Pottsville, PA 17901-3625 | 2015-05-01 |
| 1457741985 | Patti Ann Dasilva | Nurse Practitioner | 420 S Jackson St, Pottsville, PA 17901-3625 | 2015-02-04 |
| 1760804512 | Colleen Margaret Lizewski | Physician Assistant | 420 S Jackson St, Pottsville, PA 17901-3625 | 2014-01-14 |
| 1164767034 | Karen L Vigoda | Social Worker | 420 S Jackson St, 5th Floor, Pottsville, PA 17901-3625 | 2012-12-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013409762 | Culture2culture, Inc. | Community/Behavioral Health | 110 E Arch St Fl 1, Pottsville, PA 17901 | 2018-05-30 |
| 1376059444 | Stacie Marie Herring | Registered Nurse | 1400 Laurel Boulevard, Pottsville, PA 17901 | 2017-12-27 |
| 1477092567 | Dr. Scott Rosenthal, P.C. | Pain Medicine | 48 Tunnel Rd Ste 202, Pottsville, PA 17901 | 2017-02-22 |
| 1932573268 | Allied Health Care Services | Community/Behavioral Health | 320 N Second St, Pottsville, PA 17901 | 2015-11-24 |
| 1417344862 | Megan Heffron-foose | Behavioral Analyst | 221 Mahantongo Street, Pottsville, PA 17901 | 2015-04-23 |
| 1326443417 | Richard Adam Haycock | Psychiatry & Neurology | 16 South Centre St, Pottsville, PA 17901 | 2014-10-31 |
| 1245647296 | Maria Gustis | Counselor | 100 Greenbriar Road, Pottsville, PA 17901 | 2014-07-22 |
| 1790198398 | Michelle Chilinskas | Pharmacist | 500 N Claude Lord Blvd, Pottsville, PA 17901 | 2014-06-11 |
| 1952720153 | Darcie Nan Roeder | Physical Therapy Assistant | 700 E Norwegian St., Pottsville, PA 17901 | 2014-04-15 |
| 1205180858 | Rocky Mountain Holdings LLC | Ambulance | 1394 Cedar St, Pottsville, PA 17901 | 2012-11-05 |
| Find all providers in zip 17901 | ||||
| Taxonomy Code | 2085R0204X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Vascular & Interventional Radiology |
| A radiologist who diagnoses and treats diseases by various radiologic imaging modalities. These include fluoroscopy, digital radiography, computed tomography, sonography and magnetic resonance imaging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518273572 | Schuylkill Medical Center - East Norwegian Street | Radiology | 700 E Norwegian St, Pottsville, PA 17901-2710 | 2010-08-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669930798 | Mvc Pa Pllc | Radiology | 4262 Old William Penn Hwy Ste 209, Murrysville, PA 15668-1954 | 2019-03-07 |
| 1205296209 | Interventional Solutions Inc. | Radiology | 333 Allegheny Ave Ste 200, Oakmont, PA 15139-2072 | 2016-03-03 |
| 1861857906 | Lehigh Valley Vascular Institute LLC | Radiology | 3450 High Point Blvd, Bethlehem, PA 18017-7801 | 2015-12-16 |
| 1447647102 | Fresenius Vascular Care Pottstown LLC | Radiology | 2217 E High St, Pottstown, PA 19464-3215 | 2015-04-21 |
| 1891119764 | Aaron Shiloh, Md LLC | Radiology | 715 Cherry Ln, Suite 100, Southampton, PA 18966-3936 | 2014-02-12 |
| 1396081857 | Shante D Bennett | Radiology | 503 North 21st St, Camp Hill, PA 17011 | 2013-01-02 |
| 1326310806 | Pa Vascular Institute LLC | Radiology | 505 Independence Rd Ste E, East Stroudsburg, PA 18301-7916 | 2012-01-31 |
| 1699090654 | Guillaume Boiteau | Radiology | 220 S Home Ave, Apt # 404, Pittsburgh, PA 15202-2844 | 2010-04-02 |
| 1184854531 | John Yoon | Radiology | 9 N 9th St Unit 510, Philadelphia, PA 19107-3154 | 2009-07-20 |
| 1831353879 | Pennsylvania Phlebology Group PC | Radiology | 707 Eagleview Blvd Ste 303, Exton, PA 19341-1159 | 2008-07-17 |
| Find all providers with the same taxonomy | ||||
| City | POTTSVILLE |
| Zip Code | 17901 |
Please comment or provide details below to improve the information on SCHUYLKILL MEDICAL CENTER - SOUTH JACKSON STREET.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.