CONCORD MEDICAL GROUP PC (NPI# 1871510636) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871510636 |
| Entity Type | Organization |
| Organization Name | CONCORD MEDICAL GROUP PC |
| Practice Address |
210 E Main St Springville NY 14141-1442 |
| Practice Telephone | 7165923600 |
| Mailing Telephone | 7165923600 |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2008-04-20 |
| Authorized Official Name | PRISCILLA K DALE (PRESIDENT) |
| Authorized Official Telephone | 7165923000 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | ========= | NY | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 00619338 | 05 | |
| NY | GHI | 0003153 | 01 |
| NY | RR MEDICARE | C31179 | 01 |
| NY | EMPIRE | 30500G | 01 |
| Street Address |
210 E MAIN ST |
| City | SPRINGVILLE |
| State | NY |
| Zip Code | 14141-1442 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003003377 | Kathleen Prendergast | Massage Therapist | 210 E Main St, Springville, NY 14141-1442 | 2007-10-01 |
| 1902998974 | Melissa Fanton | Physician Assistant | 210 E Main St, Springville, NY 14141-1442 | 2006-09-28 |
| 1386688307 | Douglas Evan Tanner | Physician Assistant | 210 E Main St, Springville, NY 14141-1442 | 2006-06-16 |
| 1841273166 | Lori D Hudzinski | Family Medicine | 210 E Main St, Springville, NY 14141-1442 | 2005-11-21 |
| 1255313755 | Andrew J Berger | General Practice | 210 E Main St, Springville, NY 14141-1442 | 2005-11-18 |
| 1417939943 | Kenneth M Osborn | Physician Assistant | 210 E Main St, Springville, NY 14141-1442 | 2005-11-18 |
| 1821070970 | Edwin Heidelberger | Internal Medicine | 210 E Main St, Springville, NY 14141-1442 | 2005-11-15 |
| 1528069085 | William Joseph Wnuk | Internal Medicine | 210 E Main St, Springville, NY 14141-1442 | 2005-08-09 |
| 1194725275 | Priscilla K Dale | Internal Medicine | 210 E Main St, Springville, NY 14141-1442 | 2005-07-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831666114 | Lauren Victoria Manchester | Student in an Organized Health Care Education/Training Program | 290 Vaughn Street, Springville, NY 14141 | 2018-10-25 |
| 1366950479 | Buffalo Orthopaedic Group, LLP | Orthopaedic Surgery | 224 East Main St., Buffalo Orthopaedic Group, LLP, Springville, NY 14141 | 2018-01-11 |
| 1104195130 | Mary Ann Garlock | Speech-Language Pathologist | 290 North Buffalo St, Springville, NY 14141 | 2011-12-20 |
| 1124341128 | Susan K Bancroft | Pharmacist | 316 S.cascade Dr., Springville, NY 14141 | 2010-03-04 |
| 1710132204 | Rhonda C. Cecala | Licensed Practical Nurse | 337 North Buffalo Street, Springville, NY 14141 | 2008-11-25 |
| 1538340278 | Darren W Love | Pharmacist | 184 So Cascade Dr, Springville, NY 14141 | 2007-11-23 |
| 1891882320 | Theodore M Steinwachs | Physician Assistant | 24 Franklin Street, Springville, NY 14141 | 2006-10-06 |
| 1659489201 | Amy Elizabeth Schmitt-kingston | Dentist | 13832 White St, Springville, NY 14141 | 2006-08-25 |
| 1548274459 | Chiropractic Care Pllc | Chiropractor | 85 Franklin St, Springville, NY 14141 | 2006-07-28 |
| 1619922770 | Lori Ann Baker | Nurse Anesthetist, Certified Registered | Bertrand Chaffee Hospital, 224 East Main Street, Springville, NY 14141 | 2006-05-24 |
| Find all providers in zip 14141 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992159735 | Tina Cole | Specialist | 607 S 575 W, Springville, UT 84663-5957 | 2016-04-18 |
| 1891123261 | Cynthia Clark | Specialist | 12940 Mortons Corners Rd, Springville, NY 14141-9252 | 2013-10-23 |
| 1801820253 | Donna S Bennett | Specialist | 470 Brookside Dr, Springville, UT 84663-2346 | 2006-07-10 |
| 1043865785 | Lynn Smith | Specialist | 393 North St, Springville, NY 14141-9652 | 2019-08-08 |
| 1740633411 | Sarah Peffer | Specialist | 393 North St, Springville, NY 14141-9652 | 2016-07-19 |
| 1740669829 | Amanda Nolan | Specialist | 393 North St, Springville, NY 14141-9652 | 2015-05-22 |
| 1801212998 | Bonnie Abdo | Specialist | 393 North St, Springville, NY 14141-9652 | 2014-03-13 |
| 1821413139 | Megan Carroll | Specialist | 43 E Main St, Upper, Springville, NY 14141-1224 | 2014-02-24 |
| 1043650047 | Alex Broughton | Specialist | 655 E 400 S, Springville, UT 84663-2027 | 2013-07-05 |
| 1982946992 | Eileen Misiti | Specialist | 393 North St, Springville, NY 14141-9652 | 2013-03-18 |
| Find all providers in SPRINGVILLE | ||||
| City | SPRINGVILLE |
| Zip Code | 14141 |
Please comment or provide details below to improve the information on CONCORD MEDICAL GROUP PC.
| 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.