NPIMap

Organization Active NPI

DLP Conemaugh Physician Practices LLC

Doing business as Conemaugh Physician Group - Ebandjieff

  • Family Medicine Physician
  • Nanty Glo, PA
National Provider Identifier
1003222134
Registry record updated May 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
DLP CONEMAUGH PHYSICIAN PRACTICES LLC
Doing business as
Conemaugh Physician Group - Ebandjieff
Conemaugh Physician Group - Park Hill
Practice address
1060 Lloyd St
Nanty Glo, PA 15943-1232
Phone
(814) 749-8624
Fax
(814) 749-8248
NPI assigned
Jul 9, 2014
Last updated
May 14, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 14, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Charlotte Lawrence
Title
Secretary
Phone
(615) 920-7000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

1060 Lloyd St
Nanty Glo, PA 15943-1232

Mailing address

330 Seven Springs Way
Brentwood, TN 37027-5098
Phone (615) 920-7000

Other practice location 1

1940 William Penn Ave
Johnstown, PA 15909-1609
Phone (814) 322-1519

Other names 2

  • Conemaugh Physician Group - Ebandjieff Doing business as
  • Conemaugh Physician Group - Park Hill Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140915002522 PA Part B Supplier - Clinic/Group Practice 7315166949 Receives reassigned benefits from 836 practitioners
28 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment

Other NPIs on the same Medicare enrollment 28

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 28

National Provider Directory

National Provider Directory

Locations

1111 Franklin St
Ste 410
Johnstown, PA 15905
Phone (814) 536-7851

1060 Lloyd St
Nanty Glo, PA 15943
Phone (814) 536-6671

Practitioners & affiliated clinicians

Practitioners 31

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 31

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1404864000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747180800000",
    "number": "1003222134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 SEVEN SPRINGS WAY",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370275098",
            "telephone_number": "615-920-7000",
            "fax_number": "615-920-8775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1060 LLOYD ST",
            "city": "NANTY GLO",
            "state": "PA",
            "postal_code": "159431232",
            "telephone_number": "814-749-8624",
            "fax_number": "814-749-8248"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1940 William Penn Ave",
            "address_purpose": "LOCATION",
            "city": "Johnstown",
            "state": "PA",
            "postal_code": "159091609",
            "country_code": "US",
            "telephone_number": "814-322-1519",
            "fax_number": "814-322-1454",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "DLP CONEMAUGH PHYSICIAN PRACTICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-09",
        "last_updated": "2025-05-14",
        "certification_date": "2025-05-14",
        "status": "A",
        "authorized_official_last_name": "LAWRENCE",
        "authorized_official_first_name": "CHARLOTTE",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "615-920-7000"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Conemaugh Physician Group - Ebandjieff",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Conemaugh Physician Group - Park Hill",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Nanty Glo, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.