Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Clinical Care Associates of the University of Pennsylvania Health Syst

Organization Family Medicine Physician · NPI 1508380452

Clinical Care Associates of the University of Pennsylvania Health Syst is a Family Medicine Physician in Philadelphia, Pennsylvania. Works from 4 locations. Licensed in Pennsylvania.

Licensed in
PA
In the registry since
2017
Specialties on file
12
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Practice location Address checks out

1930 S Broad St Unit 28 Penn Urgent Care South Philadelphia
Philadelphia, PA 19145-2328
Phone: (215) 419-7500
Fax: (215) 419-7505
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Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (3)

  • 240 Middletown Blvd Ste 205, Langhorne, PA 19047-1832 — (215) 752-2424
  • 230 W Washington Square, Suite 102, Philadelphia, PA 19106-3500 — (215) 829-3985
  • 250 King Of Prussia Rd Fl 4, Radnor, PA 19087-5235 — (610) 902-1720

Specialties & licences

Urgent Care Clinic/Center (primary) Taxonomy 261QU0200X (PA)
Family Medicine Physician Taxonomy 207Q00000X (PA)
Hospice and Palliative Medicine (Internal Medicine) Physician Taxonomy 207RH0002X (PA)
Hospice and Palliative Medicine (Internal Medicine) Physician Taxonomy 207RH0002X
Hematology & Oncology Physician Taxonomy 207RH0003X
Clinical Pathology/Laboratory Medicine Physician Taxonomy 207ZP0105X (PA)
Neurology Physician Taxonomy 2084N0400X
Diagnostic Radiology Physician Taxonomy 2085R0202X (PA)
Surgery Physician Taxonomy 208600000X
Colon & Rectal Surgery Physician Taxonomy 208C00000X
Primary Podiatric Medicine Podiatrist Taxonomy 213EP1101X
Adult Health Nurse Practitioner Taxonomy 363LA2200X

Record details

NPI number1508380452
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Chante Jackson — Enrollment Lead · (215) 662-6187
NPI enumeratedAugust 2, 2017
Last updated in NPPESJune 9, 2021
Certification dateJune 9, 2021
Mailing address250 King Of Prussia Rd Fl 4, Radnor, PA 19087-5235

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