Organization Active NPI

1

  • Pediatric Skilled Nursing Facility
  • Mountain Top, PA
National Provider Identifier
1104246222
Registry record updated Apr 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Skilled Nursing FacilityTaxonomy code 3140N1450X
License
RN586725 Issued in PA
Legal business name
1
Practice address
14 Basswood Dr
Mountain Top, PA 18707-1824
Phone
(570) 474-0859
NPI assigned
Apr 16, 2014
Last updated
Apr 16, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2014

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

Authorized official

Name
Valerie Jane Weigand
Title
RN
Phone
(570) 474-0859

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Skilled Nursing Facility 3140N1450X RN586725 PA Primary

Addresses

Primary practice location

14 Basswood Dr
Mountain Top, PA 18707-1824

Mailing address

14 Basswood Dr
Mountain Top, PA 18707-1824
Phone (570) 474-0859

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1397606400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1397606400000",
    "number": "1104246222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 BASSWOOD DR",
            "city": "MOUNTAIN TOP",
            "state": "PA",
            "postal_code": "187071824",
            "telephone_number": "570-474-0859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 BASSWOOD DR",
            "city": "MOUNTAIN TOP",
            "state": "PA",
            "postal_code": "187071824",
            "telephone_number": "570-474-0859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "1",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-16",
        "last_updated": "2014-04-16",
        "status": "A",
        "authorized_official_last_name": "WEIGAND",
        "authorized_official_first_name": "VALERIE",
        "authorized_official_middle_name": "JANE",
        "authorized_official_title_or_position": "RN",
        "authorized_official_telephone_number": "570-474-0859"
    },
    "taxonomies": [
        {
            "code": "3140N1450X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility, Nursing Care, Pediatric",
            "state": "PA",
            "license": "RN586725",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mountain Top, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2014; 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.