NPIMap

Organization Active NPI

Nulton Diagnostic & Treatment Center, PC

  • Neurodevelopmental Disabilities Physician
  • Johnstown, PA
National Provider Identifier
1073573010
Registry record updated Sep 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurodevelopmental Disabilities PhysicianTaxonomy code 2084P0005X
Legal business name
NULTON DIAGNOSTIC & TREATMENT CENTER, PC
Practice address
214 College Park PLZ
Johnstown, PA 15904-2833
Phone
(814) 262-0025
Fax
(814) 266-8745
NPI assigned
Mar 24, 2006
Last updated
Sep 18, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2026

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

Authorized official

Name
Larry J NultonNPI 1497896906
Title
Owner
Phone
(814) 262-0025

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Neurodevelopmental Disabilities PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0005X Primary
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X
Community/Behavioral Health Agency 251S00000X 314080 PA
Community/Behavioral Health Agency 251S00000X 117055 PA

Addresses

Primary practice location

214 College Park PLZ
Johnstown, PA 15904-2833

Mailing address

214 College Park PLZ
Johnstown, PA 15904-2833
Phone (814) 262-0025

Other practice location 1

400 Lakemont Park Blvd Ste 100
Altoona, PA 16602-5967
Phone (814) 944-4722

Other practice location 2

1405 N Cedar Crest Blvd
Allentown, PA 18104-2308
Phone (888) 918-5465

Other practice location 3

10 Buist Rd Ste 304&103
Milford, PA 18337-9311
Phone (570) 686-0064

Other practice location 4

643 Main St
Slatington, PA 18080-1458
Phone (610) 224-9311

Other practice location 5

1008 S 5th Ave Ste 102
Clarion, PA 16214-8676
Phone (888) 918-5465

Other practice location 6

505 Georgian Pl
Somerset, PA 15501-1613
Phone (814) 701-2358

Other practice location 7

110 Franklin St Ste 105A
Johnstown, PA 15901-1829
Phone (877) 268-9463

Other practice location 8

608 E Pitt St
Bedford, PA 15522-9723
Phone (814) 624-3121

Other practice location 9

313 W High St Ste 211
Ebensburg, PA 15931-1549
Phone (814) 419-8083

Other practice location 10

321 Main St Ste 4F
Johnstown, PA 15901-1632
Phone (814) 254-4905

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040225000665 PA Part B Supplier - Clinic/Group Practice 5294621363 Receives reassigned benefits from 54 practitioners
1 other NPI on this enrollment
Practice locations: Johnstown, PA

Other NPIs on the same Medicare enrollment 1

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
39D2086877Nulton Diagnostic & Treatment Center214 College Park Plaza, Johnstown, PA 15904Certificate of waiverNov 12, 2026
39D2175954Nulton Diagnostic and Treatment Center643 Main Street, Slatington, PA 18080Certificate of waiverDec 4, 2027

National Provider Directory

National Provider Directory

Locations

313 W High St
Ebensburg, PA 15931
Phone (814) 205-4004

Practitioners & affiliated clinicians

Practitioners 56

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 56

NPI Registry JSON

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

{
    "created_epoch": "1143158400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1789689600000",
    "number": "1073573010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "214 COLLEGE PARK PLZ",
            "city": "JOHNSTOWN",
            "state": "PA",
            "postal_code": "159042833",
            "telephone_number": "814-262-0025",
            "fax_number": "814-266-8745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "214 COLLEGE PARK PLZ",
            "city": "JOHNSTOWN",
            "state": "PA",
            "postal_code": "159042833",
            "telephone_number": "814-262-0025",
            "fax_number": "814-266-8745"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "400 Lakemont Park Blvd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Altoona",
            "state": "PA",
            "postal_code": "166025967",
            "country_code": "US",
            "telephone_number": "814-944-4722",
            "fax_number": "814-266-2880",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1405 N Cedar Crest Blvd",
            "address_purpose": "LOCATION",
            "city": "Allentown",
            "state": "PA",
            "postal_code": "181042308",
            "country_code": "US",
            "telephone_number": "888-918-5465",
            "fax_number": "814-266-2880",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10 Buist Rd Ste 304&103",
            "address_purpose": "LOCATION",
            "city": "Milford",
            "state": "PA",
            "postal_code": "183379311",
            "country_code": "US",
            "telephone_number": "570-686-0064",
            "fax_number": "814-266-2880",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "643 Main St",
            "address_purpose": "LOCATION",
            "city": "Slatington",
            "state": "PA",
            "postal_code": "180801458",
            "country_code": "US",
            "telephone_number": "610-224-9311",
            "fax_number": "814-266-2880",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1008 S 5th Ave Ste 102",
            "address_purpose": "LOCATION",
            "city": "Clarion",
            "state": "PA",
            "postal_code": "162148676",
            "country_code": "US",
            "telephone_number": "888-918-5465",
            "fax_number": "814-266-2880",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "505 Georgian Pl",
            "address_purpose": "LOCATION",
            "city": "Somerset",
            "state": "PA",
            "postal_code": "155011613",
            "country_code": "US",
            "telephone_number": "814-701-2358",
            "fax_number": "814-266-2880",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "110 Franklin St Ste 105A",
            "address_purpose": "LOCATION",
            "city": "Johnstown",
            "state": "PA",
            "postal_code": "159011829",
            "country_code": "US",
            "telephone_number": "877-268-9463",
            "fax_number": "814-266-2880",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "608 E Pitt St",
            "address_purpose": "LOCATION",
            "city": "Bedford",
            "state": "PA",
            "postal_code": "155229723",
            "country_code": "US",
            "telephone_number": "814-624-3121",
            "fax_number": "814-266-2880",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "313 W High St Ste 211",
            "address_purpose": "LOCATION",
            "city": "Ebensburg",
            "state": "PA",
            "postal_code": "159311549",
            "country_code": "US",
            "telephone_number": "814-419-8083",
            "fax_number": "814-266-2880",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "321 Main St Ste 4F",
            "address_purpose": "LOCATION",
            "city": "Johnstown",
            "state": "PA",
            "postal_code": "159011632",
            "country_code": "US",
            "telephone_number": "814-254-4905",
            "fax_number": "814-266-2880",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "NULTON DIAGNOSTIC & TREATMENT CENTER, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-24",
        "last_updated": "2026-09-18",
        "certification_date": "2026-09-18",
        "status": "A",
        "authorized_official_last_name": "NULTON",
        "authorized_official_first_name": "LARRY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "814-262-0025"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0005X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurodevelopmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "PA",
            "license": "314080",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "PA",
            "license": "117055",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnstown, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.