NPIMap

Organization Active NPI

Divine Providence Hospital of the Sisters of Christian Charity

  • Community Health Clinic/Center
  • Williamsport, PA
National Provider Identifier
1033394564
Registry record updated Jan 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health Clinic/CenterTaxonomy code 261QC1500X
License
041001 Issued in PA
Legal business name
DIVINE PROVIDENCE HOSPITAL OF THE SISTERS OF CHRISTIAN CHARITY
Practice address
471 Hepburn St
Williamsport, PA 17701-6122
Phone
(570) 567-5400
Fax
(570) 326-8601
NPI assigned
Jan 3, 2008
Last updated
Jan 15, 2008By the provider in NPPES
Organization subpart
Yes
Parent organization
DIVINE PROVIDENCE HOSPITAL OF THE SISTERS OF CHRISTIAN CHARITYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 15, 2008

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

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Clinic/Center 261QC1500X 041001 PA Primary

Addresses

Primary practice location

471 Hepburn St
Williamsport, PA 17701-6122

Mailing address

1205 Grampian Blvd
2ND Floor
Williamsport, PA 17701-1978
Phone (570) 326-8676

Other identifiers 1

IdentifierTypeStateIssuer
1007563750029MedicaidPA

Other names 1

  • Divine Providence Hospital Other name

National Provider Directory

National Provider Directory
Tax ID family
Community Health Servic3 organizations share this tax ID, including this one
Part of
Community Health Servic

Other organizations with this tax ID 2

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

NPI Registry JSON

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

{
    "created_epoch": "1199318400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1200355200000",
    "number": "1033394564",
    "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": "471 HEPBURN ST",
            "city": "WILLIAMSPORT",
            "state": "PA",
            "postal_code": "177016122",
            "telephone_number": "570-567-5400",
            "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": "2008-01-03",
        "last_updated": "2008-01-15",
        "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": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": "PA",
            "license": "041001",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007563750029",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Divine Providence Hospital",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Jan 15, 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.