PROSPECT CCMC, LLC (NPI# 1740644053) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740644053 |
| Entity Type | Organization |
| Organization Name | PROSPECT CCMC, LLC |
| Other Organization Name | TCA SCHOOL |
| Practice Address |
710 S Middletown Rd Media PA 19063-5024 |
| Practice Telephone | 6104472000 |
| Practice Fax Number | 6104476620 |
| Mailing Telephone | 6104472000 |
| Mailing Fax Number | 6104476620 |
| Enumeration Date | 2016-04-12 |
| Last Update Date | 2016-04-12 |
| Authorized Official Name | ELLEN SHIN (SECRETARY) |
| Authorized Official Telephone | 3109434520 |
| Authorized Official Credential | JD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| tca school | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043674351 | Prospect Ccmc, LLC | Clinic/Center | 100 Crozerville Rd, Aston, PA 19014-1444 | 2016-04-12 |
| 1578927885 | Prospect Ccmc, LLC | Clinic/Center | 201 Bridgewater Rd, Chester, PA 19015-2113 | 2016-04-12 |
| 1669084364 | Prospect Ccmc, LLC | Case Management | 301 W 15th St, Chester, PA 19013-5300 | 2020-08-24 |
| 1750943445 | Prospect Ccmc, LLC | Clinic/Center | 800 Macdade Blvd, Collingdale, PA 19023-3826 | 2019-07-02 |
| 1477113249 | Prospect Ccmc, LLC | Clinic/Center | 800 Macdade Blvd, Collingdale, PA 19023-3826 | 2019-06-14 |
| 1427595982 | Prospect Ccmc, LLC | Clinic/Center | 1 Medical Center Blvd, Chester, PA 19013-3902 | 2017-01-23 |
| 1942745211 | Prospect Ccmc, LLC | Clinic/Center | 1 Medical Center Blvd, Chester, PA 19013-3902 | 2016-12-22 |
| 1659728640 | Prospect Ccmc, LLC | Clinic/Center | 1 Medical Center Blvd, Chester, PA 19013-3902 | 2016-05-19 |
| 1376990366 | Prospect Ccmc, LLC | Clinic/Center | 301 W 15th St, Chester, PA 19013 | 2016-05-19 |
| 1184071177 | Prospect Ccmc, LLC | Case Management | 301 W 15th St, Chester, PA 19013-5300 | 2016-05-19 |
| Street Address |
710 S MIDDLETOWN RD |
| City | MEDIA |
| State | PA |
| Zip Code | 19063-5024 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538766837 | Kimberly Ann Martyn | Nurse Practitioner | 168 W Baltimore Pike, Media, PA 19063 | 2020-10-08 |
| 1366060220 | Yinka Read | Clinical Neuropsychologist | 1088 W. Baltimore Pike, Healthcare II, Suite 2205, Media, PA 19063 | 2020-07-08 |
| 1306304522 | Caroline Dickerson | Speech-Language Pathologist | 510 Williamson Cir, Media, PA 19063 | 2019-03-06 |
| 1528544178 | Dayeon Cho | Nurse Practitioner | 1400 North Providence Road, Suite 1020, Rose Tree Corporate Center, Building 2, Media, PA 19063 | 2018-07-17 |
| 1235621400 | Joseph Savukinas | Registered Nurse | Mirmont Treatment Center, 100 Yearsley Mill Rd, Media, PA 19063 | 2018-06-04 |
| 1003331281 | Accredited Environmental Technologies, Inc. | Contractor | 28 N. Pennell Road, Media, PA 19063 | 2017-08-08 |
| 1538684220 | Holcomb Associates Inc. | Clinic/Center | 126 East Baltimore Pike, Gayley Square, Media, PA 19063 | 2017-08-03 |
| 1619498334 | Bryan Allen Mizell | Specialist/Technologist | 324 Crestview Circle, Media, PA 19063 | 2017-07-03 |
| 1427597970 | Grow Now Therapy Services LLC. | Speech-Language Pathologist | 600 N Jackson Street, Media, PA 19063 | 2017-02-16 |
| 1720520216 | Kathryn Rauch | Counselor | 107 Chesley Drive Unit #5, Media, PA 19063 | 2016-11-15 |
| Find all providers in zip 19063 | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306982103 | Crozer-chester Medical Center | Clinic/Center | 710 S Middletown Road, Media, PA 19063-5024 | 2007-01-29 |
| 1770985400 | Rediclinic of Pa, LLC | Clinic/Center | 510 E Baltimore Pike, Media, PA 19063-3836 | 2014-09-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144820754 | The Nava Center, Inc. | Clinic/Center | 1334 S 18th St, Philadelphia, PA 19146-4647 | 2020-11-01 |
| 1629680319 | Innovative Pediatric Therapy Services LLC | Clinic/Center | 713 Bridge St Ste 23, Selinsgrove, PA 17870-1250 | 2020-08-24 |
| 1376161828 | Cerner Health Connections, Inc | Clinic/Center | 1234 West Chester Pike, West Chester, PA 19382-5688 | 2020-07-10 |
| 1811514417 | Care Counseling & Children's Services LLC | Clinic/Center | 872 Pennsylvania St, Whitehall, PA 18052-7968 | 2020-06-30 |
| 1629694880 | Lancaster General Medical Group | Clinic/Center | 2112 Harrisburg Pike Ste 323, Lancaster, PA 17601-2644 | 2020-06-23 |
| 1225653496 | Aeo Pitt | Clinic/Center | 77 Hot Metal St, Pittsburgh, PA 15203-2382 | 2020-06-12 |
| 1174147656 | Paul Witt Do Pllc | Clinic/Center | 59 East Carey Street, Plains, PA 18705-1870 | 2020-06-01 |
| 1306469309 | Everest Pace Center Inc | Clinic/Center | 2602 W 9th St Ste 100, Chester, PA 19013-2089 | 2020-05-26 |
| 1225650930 | The Modern Country Doctor, LLC | Clinic/Center | 23 Industrial Blvd Ste D, Paoli, PA 19301-1601 | 2020-05-15 |
| 1013543099 | Rediclinic of Pa, LLC | Clinic/Center | 5707 Easton Rd, Pipersville, PA 18947-1823 | 2020-03-21 |
| Find all providers with the same taxonomy | ||||
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| 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.