NPIMap

Organization Active NPI

J C Blair Memorial Hospital

Doing business as Penn Highlands Huntingdon

  • Family Medicine Physician
  • Cassville, PA
National Provider Identifier
1013622653
Registry record updated Jan 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
J C BLAIR MEMORIAL HOSPITAL
Doing business as
Penn Highlands Huntingdon
Practice address
478 Seminary St
Cassville, PA 16623-6201
Phone
(814) 506-9060
NPI assigned
Jan 18, 2023
Last updated
Jan 18, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2023

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

Authorized official

Name
Jourdan Strishock
Title
Enrollment
Phone
(814) 375-6160

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X

Addresses

Primary practice location

478 Seminary St
Cassville, PA 16623-6201

Mailing address

100 Hospital Ave
Du Bois, PA 15801-1440
Phone (814) 375-6160

Other names 1

  • Penn Highlands Huntingdon Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120405000669 PA Part A Provider - Hospital 2668378407 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Huntingdon, PA; Cassville, PA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1013622653. Details of each certification follow.

Hospital certification: CCN 39U056

Legal name
J C BLAIR MEMORIAL HOSPITAL
Doing business as
PENN HIGHLANDS HUNTINGDON
Organization structure
CorporationNon-profit
Incorporated
Apr 12, 1909 in PA
Enrollment address
1225 Warm Springs Avenue
Huntingdon, PA 16652-2350
Hospital Swing-Bed Unit
Hospital subgroups
Swing-bed approved

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory
Tax ID family
JC Blaim Memorial Hos a31 organizations share this tax ID, including this one

Other organizations with this tax ID 30

Organizations that report the same tax identification number in the National Provider Directory.

View all 30

Ownership & related parties

All disclosed owners & managing parties 19

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Jourdan D Strishock Individual W-2 Managing Employee Aug 1, 2021
Fred Price Individual Corporate OfficerBoard Member Jan 1, 2016
Joseph E Myers Individual Corporate OfficerCeo Jan 1, 2018
Corporate DirectorCeo Jan 1, 2018
W-2 Managing EmployeeCeo Jan 1, 2018
Maria Therese Pettinger Individual Corporate Officer Jul 1, 2022
Penn Highlands Healthcare, Inc. Organization, Du Bois, PA Non-profit Operational/Managerial Control Jun 1, 2019
Mark R Minor Individual Corporate Officer Jul 1, 2022
John Coursen Individual Corporate OfficerBoard Member Jan 1, 2016
Peter M Hopsicker Individual Corporate Officer Jul 1, 2020
Allen Black Individual Corporate OfficerBoard Member Jan 1, 2016
James a Toha Individual Corporate Officer Jul 1, 2022
Kathy a Hawn Individual Corporate OfficerService Leader Business Office May 23, 2018
Corporate DirectorService Leader Business Office May 23, 2018
W-2 Managing EmployeeService Leader Business Office May 23, 2018
Cheryl E Shope Individual Corporate Officer Jul 1, 2020
Michael J Sabatini Individual Corporate Officer Jul 1, 2020
Wanda L Curfman Barnett Individual Corporate OfficerSenior Executive Assistant May 23, 2018
Corporate DirectorSenior Executive Assistant May 23, 2018
W-2 Managing EmployeeSenior Executive Assistant May 23, 2018
Oscar W Johnston Individual Corporate Officer Jul 1, 2020
Antionette L Gray Individual Corporate Officer Jul 1, 2022
Margaret M Hallahan Individual Corporate Officer Jun 1, 2019
Frances Vaughn Individual Corporate OfficerBoard Member Jan 1, 2016
Miranda Peruso Individual Corporate OfficerBoard Member Jan 1, 2016

Owners & managing parties with NPI records 3

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

NPI Registry JSON

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

{
    "created_epoch": "1674000000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674000000000",
    "number": "1013622653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 HOSPITAL AVE",
            "city": "DU BOIS",
            "state": "PA",
            "postal_code": "158011440",
            "telephone_number": "814-375-6160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "478 SEMINARY ST",
            "city": "CASSVILLE",
            "state": "PA",
            "postal_code": "166236201",
            "telephone_number": "814-506-9060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J C BLAIR MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-18",
        "last_updated": "2023-01-18",
        "certification_date": "2023-01-18",
        "status": "A",
        "authorized_official_last_name": "STRISHOCK",
        "authorized_official_first_name": "JOURDAN",
        "authorized_official_title_or_position": "ENROLLMENT",
        "authorized_official_telephone_number": "814-375-6160"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Penn Highlands Huntingdon",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cassville, PA

Sources for this page

Verify at the official NPI Registry.