SCHUYLKILL MEDICAL CENTER - SOUTH JACKSON STREET (NPI# 1629303961) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629303961 |
| Entity Type | Organization |
| Organization Name | SCHUYLKILL MEDICAL CENTER - SOUTH JACKSON STREET |
| Other Organization Name | SCHUYLKILL MEDICAL CENTER - SOUTH JACKSON STREET TCU |
| 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 | 2009-10-05 |
| Last Update Date | 2009-10-05 |
| Authorized Official Name | MR. JOHN E. SIMODEJKA (PRESIDENT AND CEO) |
| Authorized Official Telephone | 5706215000 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| SCHUYLKILL MEDICAL CENTER - SOUTH JACKSON STREET TCU | Other Name - Individual/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 |
| 1487960530 | Schuylkill Medical Center - South Jackson Street | Radiology | 420 S Jackson St, Pottsville, PA 17901-3625 | 2010-08-27 |
| 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 | 314000000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. |
| Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952346413 | Schuylkill Nursing Homes, Inc. | Skilled Nursing Facility | 1000 Schuylkill Manor Rd, Pottsville, PA 17901-3862 | 2006-06-18 |
| 1508813460 | Manor Care of Pottsville Pa LLC | Skilled Nursing Facility | 420 Pulaski Dr, Pottsville, PA 17901-3634 | 2006-05-27 |
| 1386695617 | Ggnsc Pottsville Lp | Skilled Nursing Facility | 2401 W Market St, Pottsville, PA 17901-1833 | 2006-05-12 |
| 1346783685 | The Meadows At Pottsville for Nursing and Rehabilitation LLC | Skilled Nursing Facility | 2401 W Market St, Pottsville, PA 17901-1833 | 2016-11-18 |
| 1699031492 | Genesis Rehab Services | Skilled Nursing Facility | 1000 Schuylkill Manor Rd, Pottsville, PA 17901-3862 | 2012-04-05 |
| 1730361056 | 1000 Schuylkill Manor Road Operations LLC | Skilled Nursing Facility | 1000 Schuylkill Manor Rd, Pottsville, PA 17901-3862 | 2007-11-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851990675 | Elizabethtown Opco LLC | Skilled Nursing Facility | 141 Heisey Avenue, Elizabethtown, PA 17022-8107 | 2020-10-22 |
| 1689273500 | Southwestern Healthcare Operations LLC | Skilled Nursing Facility | 500 Lewis Run Road, Pittsburgh, PA 15122-3056 | 2020-10-21 |
| 1922626290 | Brsi, Lp | Skilled Nursing Facility | 303 Walnut St Fl 7, Harrisburg, PA 17101-1825 | 2020-07-13 |
| 1932727591 | 1425 Horsham Snf Operations LLC | Skilled Nursing Facility | 1425 Horsham Road, North Wales, PA 19454-1320 | 2020-07-10 |
| 1184242182 | Conestoga View Snf Operations LLC | Skilled Nursing Facility | 900 E King Street, Lancaster, PA 17602-3272 | 2020-07-07 |
| 1164040168 | Mountain View Snf Operations LLC | Skilled Nursing Facility | 2050 Trevorton Road, Coal Township, PA 17866-9405 | 2020-07-07 |
| 1508484502 | Timber Ridge Snf Operations LLC | Skilled Nursing Facility | 1555 East End Boulevard, Plains Twp, PA 18702-7927 | 2020-07-07 |
| 1205456704 | Embassy Sharon, LLC | Skilled Nursing Facility | 959 E. State Street, Sharon, PA 16146 | 2020-04-24 |
| 1952940785 | Newport Meadows Health and Rehabilitation Center LLC | Skilled Nursing Facility | 41 Newport Avenue, Christina, PA 17509-1305 | 2019-12-26 |
| 1851954176 | Silvercare Skilled Nursing LLC | Skilled Nursing Facility | 2600 W 9th St Unit A, Chester, PA 19013-2040 | 2019-04-22 |
| 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.