MAIN LINE URGENT CARE MEDICAL GROUP, P.C. (NPI# 1477848422) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477848422 |
| Entity Type | Organization |
| Organization Name | MAIN LINE URGENT CARE MEDICAL GROUP, P.C. |
| Other Organization Name | CARESTAT URGENT CARE CENTERS |
| Practice Address |
1305 W Chester Pike Havertown PA 19083-2929 |
| Mailing Address |
1505 E Churchville Rd Bel Air MD 21014-4742 |
| Practice Telephone | 4104206970 |
| Mailing Telephone | 4104206970 |
| Mailing Fax Number | 4104206967 |
| Enumeration Date | 2011-06-16 |
| Last Update Date | 2018-05-04 |
| Authorized Official Name | MAURICE REID (CEO) |
| Authorized Official Telephone | 4105690044 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QU0200X |
Clinic/Center Specialization: Urgent Care |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | NPI REGISTRY | 1891792255 | 01 |
| Other Name | Type Code |
|---|---|
| CareSTAT Urgent Care Centers | Doing Business As Name - Organization |
| Street Address |
1305 W CHESTER PIKE |
| City | HAVERTOWN |
| State | PA |
| Zip Code | 19083-2929 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891792255 | Jonathan Gusdorff | Specialist | 1305 W Chester Pike, Havertown, PA 19083-2929 | 2005-06-30 |
| 1255836789 | On Demand Urgent Care Group, PC | Clinic/Center | 1305 W Chester Pike, Havertown, PA 19083-2929 | 2018-03-27 |
| 1366822280 | Kerry Ries | Physician Assistant | 1305 W Chester Pike, Havertown, PA 19083-2929 | 2015-06-05 |
| 1366856916 | Kelly Gilmer | Pharmacist | 1305 W Chester Pike, Suite 8, Havertown, PA 19083-2929 | 2014-06-11 |
| 1194038299 | Joseph G Castellano | Pharmacist | 1305 W Chester Pike, Havertown, PA 19083-2929 | 2010-07-16 |
| 1285805820 | Jeanne-marie Pennington | Physician Assistant | 1305 W Chester Pike, Havertown, PA 19083-2929 | 2008-03-21 |
| 1952330276 | Frederic C Stieg | Family Medicine | 1305 W Chester Pike, Havertown, PA 19083-2929 | 2006-06-30 |
| 1689644791 | Walter J Adamek | Emergency Medicine | 1305 W Chester Pike, Havertown, PA 19083-2929 | 2006-01-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043835457 | Kelly Anne Clarke | Counselor | American Treatment Network Physician & Associates, 1120 Township Line Road, Havertown, PA 19083 | 2020-06-11 |
| 1588216238 | Angela Wrolstad | Registered Nurse | 614 Darby Road, Havertown, PA 19083 | 2019-07-12 |
| 1639696214 | Osaru Anyumba | Case Manager/Care Coordinator | 311 Lansdowne Road, Havertown, PA 19083 | 2017-08-24 |
| 1346762739 | Luke Francis Mattson | Pharmacist | 60 West Hillcrest Avenue, Havertown, PA 19083 | 2017-07-07 |
| 1124558150 | Clare M Chakey | Counselor | 1631 Ridgeway Road, Haventown, PA 19083 | 2017-06-13 |
| 1205382553 | Silverware Home Care Service LLC | Residential Treatment Facility, Physical Disabilities | 2010 Wester Chester Pike, Suite 448, Havertown, PA 19083 | 2016-08-28 |
| 1275903486 | Megan Keeley Ramaika | Dietitian, Registered | 404 Fairmont Road, Havertown, PA 19083 | 2015-09-30 |
| 1972987246 | Katie Paugh | Occupational Therapist | One North Belfield Avenue, Havertown, PA 19083 | 2015-07-16 |
| 1497140180 | Total Health Home Care Corporation | Nurse's Aide | 2710 West Township Line Rd, Havertown, PA 19083 | 2015-03-31 |
| 1851704084 | Ul Sik Jason Chong | Pharmacist | 700 East Townshipline Road Ste Ll, Havertown, PA 19083 | 2014-06-05 |
| Find all providers in zip 19083 | ||||
| Taxonomy Code | 261QU0200X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Urgent Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255836789 | On Demand Urgent Care Group, PC | Clinic/Center | 1305 W Chester Pike, Havertown, PA 19083-2929 | 2018-03-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962022574 | Nurse Practitioners of The Valley, LLC | Clinic/Center | 3910 Adler Pl Ste 135, Bethlehem, PA 18017-9299 | 2020-04-23 |
| 1154968709 | On Demand Urgent Care Group PC | Clinic/Center | 5828 Market St, Philadelphia, PA 19139-3152 | 2019-12-03 |
| 1447891452 | On Demand Urgent Care Group, PC | Clinic/Center | 3626 Street Rd, Bensalem, PA 19020-1507 | 2019-10-01 |
| 1205486891 | Mydoc Urgent Care Chinatown | Clinic/Center | 1008 Arch St Ste 102, Philadelphia, PA 19107-3002 | 2019-09-16 |
| 1558917120 | All American Urgent Care, P.C. | Clinic/Center | 780 N Krocks Rd Ste 101, Allentown, PA 18106-9075 | 2019-08-10 |
| 1477118420 | Mhp Cheltenham LLC | Clinic/Center | 2401 W Cheltenham Ave Ste 132, Wyncote, PA 19095-2953 | 2019-05-06 |
| 1053873091 | Summit Physician Services | Clinic/Center | 24 Antrim Commons Drive, Greencastle, PA 17225-1623 | 2019-04-01 |
| 1114491594 | On Demand Urgent Care Group PC | Clinic/Center | 1500 Spring Garden St Ste R105, Philadelphia, PA 19130-4067 | 2019-01-18 |
| 1043797160 | Urgent Care Travel, Inc | Clinic/Center | 1501 Harrisburg Pike, Carlisle, PA 17015-7306 | 2018-07-21 |
| 1538667704 | Premier Urgent Care At Kennett Square, LLC | Clinic/Center | 10050 Roosevelt Blvd Ste 2, Philadelphia, PA 19116-3965 | 2018-01-23 |
| 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.