NPIMap

Organization Active NPI

Divine Providence Hospital of the Sisters of Christian Charity

  • Registered Nurse
  • Williamsport, PA
National Provider Identifier
1023141306
Registry record updated Apr 6, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
700605 Issued in PA
Legal business name
DIVINE PROVIDENCE HOSPITAL OF THE SISTERS OF CHRISTIAN CHARITY
Practice address
1100 Grampian Blvd
4 South
Williamsport, PA 17701-1909
Phone
(570) 320-7690
Fax
(570) 320-7898
NPI assigned
Mar 14, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2009

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

Authorized official

Name
Mr. Charles Santangelo
Title
Executive Vice President Cfo
Phone
(570) 321-3171

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered NurseGroup: 193400000X SINGLE SPECIALTY GROUP 163W00000X 700605 PA Primary
Nursing Care Agency 251J00000X 700605 PA

Addresses

Primary practice location

1100 Grampian Blvd
4 South
Williamsport, PA 17701-1909

Mailing address

1100 Grampian Blvd
4 South
Williamsport, PA 17701-1909
Phone (570) 320-7690

Other names 1

  • Susquehanna Home Care & Hospice Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Diabetes Center Divine3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

1100 Grampian Blvd
#4S
Williamsport, PA 17701
Phone (570) 320-7690

NPI Registry JSON

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

{
    "created_epoch": "1173830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1238976000000",
    "number": "1023141306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 GRAMPIAN BLVD",
            "address_2": "4 SOUTH",
            "city": "WILLIAMSPORT",
            "state": "PA",
            "postal_code": "177011909",
            "telephone_number": "570-320-7690",
            "fax_number": "570-320-7898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 GRAMPIAN BLVD",
            "address_2": "4 SOUTH",
            "city": "WILLIAMSPORT",
            "state": "PA",
            "postal_code": "177011909",
            "telephone_number": "570-320-7690",
            "fax_number": "570-320-7898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVINE PROVIDENCE HOSPITAL OF THE SISTERS OF CHRISTIAN CHARITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-14",
        "last_updated": "2009-04-06",
        "status": "A",
        "authorized_official_last_name": "SANTANGELO",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "EXECUTIVE VICE PRESIDENT CFO",
        "authorized_official_telephone_number": "570-321-3171",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse",
            "state": "PA",
            "license": "700605",
            "primary": true
        },
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": "PA",
            "license": "700605",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Susquehanna Home Care & Hospice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Williamsport, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2009; 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.