SEWICKLEY VALLEY MEDICAL GROUP, INC. (NPI# 1215079025) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215079025 |
| Entity Type | Organization |
| Organization Name | SEWICKLEY VALLEY MEDICAL GROUP, INC. |
| Practice Address |
300 Penn Lincoln Dr Imperial PA 15126-9772 |
| Mailing Address |
5626 Oberlin Dr Suite 110 San Diego CA 92121-1705 |
| Practice Telephone | 7246952411 |
| Enumeration Date | 2007-02-12 |
| Last Update Date | 2012-10-17 |
| Authorized Official Name | KENNY HEINE (DIRECTOR OF OPERATIONS) |
| Authorized Official Telephone | 8586252990 |
| Is Organization Subpart | Y |
| Parent Organization Name | MEDVANTX, INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332900000X | Non-Pharmacy Dispensing Site | MD059981L | PA | Suppliers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154624807 | Sewickley Valley Medical Group, Inc. | Internal Medicine | 935 Thorn Run Rd, Coraopolis, PA 15108-2861 | 2010-12-17 |
| 1396888004 | Sewickley Valley Medical Group, Inc. | Non-Pharmacy Dispensing Site | 2360 Hospital Dr, Aliquippa, PA 15001-2120 | 2007-02-14 |
| 1477694180 | Sewickley Valley Medical Group, Inc. | Non-Pharmacy Dispensing Site | 1101 5th Ave, Coraopolis, PA 15108-1577 | 2007-02-08 |
| Street Address |
300 PENN LINCOLN DR |
| City | IMPERIAL |
| State | PA |
| Zip Code | 15126-9772 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023095981 | Bonnie Sue Rodgers | Nurse Practitioner | 300 Penn Lincoln Dr, Imperial, PA 15126-9772 | 2005-12-30 |
| 1821433921 | Bradley W Heiple | Family Medicine | 300 Penn Lincoln Dr, Imperial, PA 15126-9772 | 2013-05-02 |
| 1285886861 | Heritage Valley Medical Group, Inc | Family Medicine | 300 Penn Lincoln Dr, Imperial, PA 15126-9772 | 2008-10-15 |
| 1740404664 | Marlynn Singleton | Family Medicine | 300 Penn Lincoln Dr, Imperial, PA 15126-9772 | 2007-04-12 |
| 1285656041 | Todd A Mccaslin | Family Medicine | 300 Penn Lincoln Dr, Imperial, PA 15126-9772 | 2006-07-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871998658 | Renee Lesko | Massage Therapist | 120 West Allegheny Road, Suite 2, Imperial, PA 15126 | 2014-10-23 |
| 1427018084 | Jay Douglas Loeb | Chiropractor | 490 Penn Lincoln Dr, Imperial, PA 15126 | 2006-03-27 |
| 1598391344 | Sarah Larue | Dentist | 703 Tamarack Dr, Imperial, PA 15126-1156 | 2020-03-12 |
| 1104432616 | Zach Quince | Student in an Organized Health Care Education/Training Program | 370 Birch St, Imperial, PA 15126-1158 | 2020-09-20 |
| 1104233147 | Vincenzo Sebastiani | Occupational Therapy Assistant | 806 Ponderosa Dr, Imperial, PA 15126-1169 | 2014-07-22 |
| 1386807154 | Heather Rae Mangieri | Dietitian, Registered | 815 Ponderosa Dr, Imperial, PA 15126-1170 | 2008-07-02 |
| 1609809078 | Milo Mark Ujevich | Radiology | 839 Ponderosa Dr, Imperial, PA 15126-1170 | 2006-07-09 |
| 1649435280 | Heather Mangieri Nutrition, LLC | Dietitian, Registered | 815 Ponderosa Dr, Imperial, PA 15126-1170 | 2008-07-23 |
| 1336467026 | Sharon A Glover | Occupational Therapist | 30 Moore Rd, Imperial, PA 15126-2215 | 2010-05-05 |
| 1487253290 | Peter Heh | Behavioral Analyst | 1690 Kennedy Rd, Imperial, PA 15126-9130 | 2020-10-22 |
| Find all providers in zip 15126 | ||||
| Taxonomy Code | 332900000X |
| Grouping | Suppliers |
| Classification | Non-Pharmacy Dispensing Site |
| A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.) |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
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| 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.