NPIMap

Organization Active NPI

Broad Top Area Medical Center Inc

Doing business as BTAMC Trough Creek Medical Center

  • Federally Qualified Health Center (FQHC)
  • Cassville, PA
National Provider Identifier
1043766611
Registry record updated Aug 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
BROAD TOP AREA MEDICAL CENTER INC
Doing business as
BTAMC Trough Creek Medical Center
Trough Creek Medical Center
Practice address
358 Seminary St
Cassville, PA 16623-6203
Phone
(814) 448-9226
Fax
(814) 448-2068
NPI assigned
Sep 1, 2016
Last updated
Aug 28, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
BROAD TOP AREA MEDICAL CENTER INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 28, 2026

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

Authorized official

Name
Shani Reed
Title
Director, Enrollment
Phone
(814) 506-8463

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X NU Primary

Addresses

Primary practice location

358 Seminary St
Cassville, PA 16623-6203

Mailing address

4133 Medical Center Dr
Broad Top, PA 16621-9001
Phone (814) 635-2916

Other names 2

  • BTAMC Trough Creek Medical Center Doing business as
  • Trough Creek Medical Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20050420000158 PA Part B Supplier - Clinic/Group Practice 2860430972 Receives reassigned benefits from 35 practitioners
13 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Orbisonia, PA; Mount Union, PA; Broad Top, PA; Huntingdon, PA; Cassville, PA; Belleville, PA; Alexandria, PA
O20170112001174 PA Part A Provider - Federally Qualified Health Center (FQHC) 2860430972 Practice locations: Cassville, PA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1043766611. Details of each certification follow.

Federally qualified health center certification: CCN 391087

Legal name
BROAD TOP AREA MEDICAL CENTER INC
Doing business as
BTAMC TROUGH CREEK MEDICAL CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jan 28, 2017
Last certification
Jan 28, 2017
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Mar 8, 1971 in PA
Enrollment address
358 Seminary St
Cassville, PA 16623-6203

Other NPIs with the same Medicare PAC ID 11

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 11

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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
39D1100656Trough Creek Medical Center358 Seminary St, Cassville, PA 16623Certificate of waiverJun 8, 2027

National Provider Directory

National Provider Directory
Tax ID family
Brroad Top Area Medical10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

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

Locations

478 Seminary St
Cassville, PA 16623
Phone (814) 448-9226

Ownership & related parties

All disclosed owners & managing parties 16

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

NameRoleSinceShare
Jennifer McMullen Individual Corporate DirectorBoard Member Apr 1, 2025
Michael Zinobile Individual Corporate OfficerChief Operating Officer (Coo) Jul 1, 2025
Kevin Nester Individual Corporate DirectorBoard Member Apr 1, 2025
Donna McCabe Individual Corporate DirectorBoard Member Aug 1, 2016
Shani Reed Individual Corporate DirectorDirector, Provider Enrollment Jan 1, 2019
Operational/Managerial ControlDirector, Provider Enrollment Jan 1, 2019
Malvin Deluca Individual Corporate DirectorBoard President Nov 21, 2012
Margaret Stiffler Individual Corporate DirectorBoard Member Apr 1, 2025
Wendy Melius Individual Corporate DirectorBoard Vice President Jun 1, 2016
John D. Roth Individual Corporate OfficerCeo Nov 30, 2018
Corporate DirectorChief Executive Officer (Ceo) Nov 30, 2018
Ronald Hayduk Individual Corporate DirectorBoard Member Apr 1, 2025
Robert Colton Individual Corporate DirectorBoard Member Mar 23, 2023
Matthew Stoudnour Individual Corporate DirectorBoard Member Mar 28, 2019
Jill Slowakiewicz Individual Corporate DirectorBoard Member Jun 24, 2021
Wayne N Fisher Individual Corporate DirectorBoard Member Jun 22, 2017
Christopher Crawshaw Individual Corporate OfficerCfo Feb 1, 2019
Theresa R Thorpe Individual Corporate DirectorBoard Member Oct 27, 2022

Owners & managing parties with NPI records 1

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

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 15

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 15

NPI Registry JSON

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

{
    "created_epoch": "1472688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1787875200000",
    "number": "1043766611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4133 MEDICAL CENTER DR",
            "city": "BROAD TOP",
            "state": "PA",
            "postal_code": "166219001",
            "telephone_number": "814-635-2916",
            "fax_number": "814-635-2918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "358 SEMINARY ST",
            "city": "CASSVILLE",
            "state": "PA",
            "postal_code": "166236203",
            "telephone_number": "814-448-9226",
            "fax_number": "814-448-2068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROAD TOP AREA MEDICAL CENTER INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BROAD TOP AREA MEDICAL CENTER INC",
        "enumeration_date": "2016-09-01",
        "last_updated": "2026-08-28",
        "certification_date": "2026-08-28",
        "status": "A",
        "authorized_official_last_name": "REED",
        "authorized_official_first_name": "SHANI",
        "authorized_official_title_or_position": "DIRECTOR, ENROLLMENT",
        "authorized_official_telephone_number": "814-506-8463"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BTAMC Trough Creek Medical Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Trough Creek Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cassville, PA

Sources for this page

Verify at the official NPI Registry.