NPIMap

Organization Active NPI

DLP Conemaugh Memorial Medical Center LLC

Doing business as Memorial Behavioral Health Unit - Gero

  • Psychiatric Hospital Unit
  • Johnstown, PA
National Provider Identifier
1053496893
Registry record updated Apr 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric Hospital UnitTaxonomy code 273R00000X
License
035601 Issued in PA
Legal business name
DLP CONEMAUGH MEMORIAL MEDICAL CENTER LLC
Doing business as
Memorial Behavioral Health Unit - Gero
Practice address
1020 Franklin St
8TH Floor
Johnstown, PA 15905-4109
Phone
(814) 534-1980
Fax
(814) 534-1810
NPI assigned
Oct 26, 2006
Last updated
Apr 29, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2024

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

Authorized official

Name
Charlotte Lawrence
Title
Secretary
Phone
(615) 920-7000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital Unit 273R00000X 035601 PA Primary

Addresses

Primary practice location

1020 Franklin St
8TH Floor
Johnstown, PA 15905-4109

Mailing address

330 Seven Springs Way
Brentwood, TN 37027-4536
Phone (615) 920-7000

Other identifiers 3

IdentifierTypeStateIssuer
0148OtherPABLUE CROSS PSYCH
100756849MedicaidPA
789567OtherPAPROFEE PSYCH

Other names 1

  • Memorial Behavioral Health Unit - Gero Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address direct@direct.conemaugh.org

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20141008000080 PA Part A Provider - Hospital 8022238682 Practice locations: Johnstown, PA

NPI to CCN mapping 2

The Medicare certification numbers (CCNs) connected to NPI 1053496893. Details of each certification follow.

Hospital certification: CCN 39S110

Legal name
DLP CONEMAUGH MEMORIAL MEDICAL CENTER LLC
Doing business as
CONEMAUGH MEMORIAL MEDICAL CENTER
Organization structure
LLCProprietary
Incorporated
May 28, 2014 in DE
Enrollment address
1086 Franklin Street
Johnstown, PA 15905-4109
Hospital Psychiatric Unit
Hospital subgroups
Psychiatric unit

Hospital certification: CCN 390060

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
GOOD SAMARITAN MEDICAL CENTER
Certification status
Terminated Voluntary: merger or closure, Jan 1, 1998
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Feb 25, 1988
Beds
179 (157 certified)
Ownership / control type
Church
Facility address
1020 Franklin St
Johnstown, PA 15905

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

Other NPIs with the same Medicare PAC ID 5

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

National Provider Directory

National Provider Directory

Locations

1020 Franklin St
Fl 8
Johnstown, PA 15905
Phone (814) 534-1927

Ownership & related parties

All disclosed owners & managing parties 13

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

NameRoleSinceShare
DSB Acquisition LLC Organization, New York, NY LLC, Investment firm, For-profit 5% Or Greater Indirect Ownership Interest Nov 16, 2018 97%
Rodney D Reider Individual Corporate OfficerMarket President/Hospital Ceo Feb 20, 2023
W-2 Managing Employee Feb 20, 2023
Elmer B Polite Individual Corporate OfficerPresident Dec 14, 2020
Lifepoint Health Inc Organization, Brentwood, TN Corporation, For-profit, Chain home office, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Nov 16, 2018 97%
Marcus B Poppell Individual Corporate OfficerSenior Vice President Nov 16, 2018
Charlotte E Lawrence Individual Corporate OfficerSecretary Mar 24, 2022
DLP Partner LLC Organization, Brentwood, TN LLC, Management services company Operational/Managerial Control Sep 1, 2014
Elliott Brown Individual Corporate OfficerSVP & Treasurer Apr 2, 2026
DLP Conemaugh Holding Company LLC Organization, Brentwood, TN LLC, Holding company, For-profit 5% Or Greater Direct Ownership Interest May 28, 2014 100%
Phillip Sensing Individual Corporate OfficerCfo May 4, 2026
DLP Lima Partner, LLC Organization, Brentwood, TN LLC, For-profit 5% Or Greater Indirect Ownership Interest Dec 18, 2019 97%
Christopher J Monte Individual Corporate OfficerVice President May 28, 2014
Lima Holdco LLC Organization, Brentwood, TN LLC, Holding company, For-profit 5% Or Greater Indirect Ownership Interest Dec 18, 2019 97%

Facilities with the same owner 87

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 87

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714348800000",
    "number": "1053496893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 SEVEN SPRINGS WAY",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370274536",
            "telephone_number": "615-920-7000",
            "fax_number": "615-920-8913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 FRANKLIN ST",
            "address_2": "8TH FLOOR",
            "city": "JOHNSTOWN",
            "state": "PA",
            "postal_code": "159054109",
            "telephone_number": "814-534-1980",
            "fax_number": "814-534-1810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DLP CONEMAUGH MEMORIAL MEDICAL CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-26",
        "last_updated": "2024-04-29",
        "certification_date": "2024-04-29",
        "status": "A",
        "authorized_official_last_name": "LAWRENCE",
        "authorized_official_first_name": "CHARLOTTE",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "615-920-7000"
    },
    "taxonomies": [
        {
            "code": "273R00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Unit",
            "state": "PA",
            "license": "035601",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS PSYCH",
            "identifier": "0148",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100756849",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROFEE PSYCH",
            "identifier": "789567",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "direct@direct.conemaugh.org",
            "affiliation": "N",
            "address_1": "1020 Franklin St",
            "address_2": "8th Floor",
            "city": "Johnstown",
            "state": "PA",
            "country_code": "US",
            "postal_code": "159054109",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Memorial Behavioral Health Unit - Gero",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Memorial Behavioral Health Unit - Gero",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Johnstown, PA

Sources for this page

Verify at the official NPI Registry.