Keystone Rural Health Consortia, Inc.
Organization Active NPI Federally Qualified Health Center (FQHC) · Kersey, PA
NPI 1053784942 · NPPES record last updated Oct 26, 2016
Key facts
- NPI
- 1053784942
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Federally Qualified Health Center (FQHC) 261QF0400X
- Legal business name
- KEYSTONE RURAL HEALTH CONSORTIA, INC.
- Practice address
- 172 Skyline Drive
Kersey, PA 15846 - Phone
- (814) 486-1115
- NPI assigned
- Nov 2, 2015
- Organization subpart
- No
Authorized official
- Name
- Kristie Bennardi, RN
- Title
- Ceo
- Phone
- (814) 486-1115
Other NPIs on the same Medicare enrollment 3
Practitioners 1
-
Mahmud Ali, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20050412000691 | PA | Part B Supplier - Clinic/Group Practice | 8022055078 |
Receives reassigned benefits from 11 practitioners 3 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Emporium, PA; Kane, PA; Ridgway, PA |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Federally Qualified Health Center (FQHC) | 261QF0400X | Yes |
Addresses
Primary practice location
172 Skyline Drive
Kersey, PA 15846
Mailing address
90 E 2ND St
Emporium, PA 15834-1302
Phone (814) 486-1115
Other providers in Kersey, PA
- Casey J Johnston
- April Lynn Kalgren
- Keebler Chiropractic PC
- Benjamin David Keebler
- Jo Anne Keller
- Keystone Rural Health Consortia, Inc.
- Julie Ann Miller
- Lori Ann Minard
- Sharon Price
- Allison Quagliani
All providers in Kersey, PA · Federally Qualified Health Center (FQHC) in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 26, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.