Divine Providence Hospital of the Sisters of Christian Charity

Primary specialty

End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X

License

041001 Issued in PA

Legal business name

DIVINE PROVIDENCE HOSPITAL OF THE SISTERS OF CHRISTIAN CHARITY

Practice address

21 Susquehanna Valley Mall Drive
Suite D
Selinsgrove, PA 17870

Phone

(570) 374-5454

Fax

(570) 326-8601

NPI assigned

Sep 5, 2006

Last updated

Apr 20, 2008By the provider in NPPES

Organization subpart

Yes

Parent organization

DIVINE PROVIDENCE HOSPITAL OF THE SISTERS OF CHRISTIAN CHARITYAs reported in NPPES

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

Authorized official

Name

Mr. Charles J. Santangelo, CPA FHFMA

Title

Executive VP Cfo

Phone

(570) 321-3171

Specialties & licenses 1

Addresses

Other names 1

• Divine Providence Hospital Other name

Part of

Convenient Care Phys

Locations

Practitioners 2

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.

• Terry Alan Belles, MD

  • Family Medicine Physician
  • South Williamsport, PA
  • NPI 1457314122
  NPD (past)
• Donald Joel Leathers, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Williamsport, PA
  • NPI 1629181797
  NPD (past)

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

{
    "created_epoch": "1157414400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1023110459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1205 GRAMPIAN BLVD",
            "address_2": "2ND FLOOR",
            "city": "WILLIAMSPORT",
            "state": "PA",
            "postal_code": "177011978",
            "telephone_number": "570-326-8676",
            "fax_number": "570-326-8601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 SUSQUEHANNA VALLEY MALL DRIVE",
            "address_2": "SUITE D",
            "city": "SELINSGROVE",
            "state": "PA",
            "postal_code": "17870",
            "telephone_number": "570-374-5454",
            "fax_number": "570-326-8601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVINE PROVIDENCE HOSPITAL OF THE SISTERS OF CHRISTIAN CHARITY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DIVINE PROVIDENCE HOSPITAL OF THE SISTERS OF CHRISTIAN CHARITY",
        "enumeration_date": "2006-09-05",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "SANTANGELO",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "EXECUTIVE VP CFO",
        "authorized_official_telephone_number": "570-321-3171",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CPA FHFMA"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "PA",
            "license": "041001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Divine Providence Hospital",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Krystin Devine, M.S., NCC, LPC
• DH&L Ambulance League
• Mark E Dincher, DMD
• Tara Lynn Dively, M.A., LMFT
• Diversified Construction, Inc.
• Anthony DO, O.D.
• Christine S. Dotterer, MD
• Dr. Henry G Yavorek MD
• Laurie Drick, OTR/L
• Brandon Dunkle, RPH

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Selinsgrove, PA
• Providers in Selinsgrove, PA by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.