NPIMap

Organization Active NPI

DLP Conemaugh Memorial Medical Center LLC

  • Rehabilitation Hospital Unit
  • Johnstown, PA
National Provider Identifier
1104909654
Registry record updated Apr 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Hospital UnitTaxonomy code 273Y00000X
License
035601 Issued in PA
Legal business name
DLP CONEMAUGH MEMORIAL MEDICAL CENTER LLC
Practice address
320 Main St
4TH Floor
Johnstown, PA 15901-1601
Phone
(814) 534-7900
Fax
(814) 534-7930
NPI assigned
Oct 20, 2006
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
Rehabilitation Hospital Unit 273Y00000X 035601 PA Primary

Addresses

Primary practice location

320 Main St
4TH Floor
Johnstown, PA 15901-1601

Mailing address

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

Other identifiers 2

IdentifierTypeStateIssuer
1007568490080MedicaidPA
1068OtherPABLUE CROSS CRICHTON

Other names 1

  • Memorial Medical Center - Crichton Rehabilitation Center Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address direct@direct.comemaugh.org

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20141008001035 PA Part A Provider - Hospital 8022238682 Practice locations: Johnstown, PA

Hospital certification: CCN 39T110

Legal name
DLP CONEMAUGH MEMORIAL MEDICAL CENTER LLC
Doing business as
CRICHTON REHABILITATION CENTER
Organization structure
LLCProprietary
Incorporated
May 28, 2014 in DE
Enrollment address
320 Main Street 4TH Floor
Crichton Rehabilitation Center
Johnstown, PA 15905-4305
Hospital Rehabilitation Unit
Hospital subgroups
Rehabilitation unit

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).

Care Compare: Inpatient rehabilitation facility

Medicare Care Compare
Listed as
Crichton Rehabilitation CenterCCN 39T110
Ownership
For profit
Certified
Jul 1, 1996

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
39D0921978Crichton Rehabilitation Center320 Main Street, Johnstown, PA 15901Certificate of waiverNov 11, 2026

National Provider Directory

National Provider Directory
Tax ID family
DLP Conemaugh Memorial Medical Center LLC9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

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

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 Jun 1, 2023
Lifepoint Health Inc Organization, Brentwood, TN Corporation, For-profit 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 OfficerSenior Vice President & 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.

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714348800000",
    "number": "1104909654",
    "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": "320 MAIN ST",
            "address_2": "4TH FLOOR",
            "city": "JOHNSTOWN",
            "state": "PA",
            "postal_code": "159011601",
            "telephone_number": "814-534-7900",
            "fax_number": "814-534-7930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DLP CONEMAUGH MEMORIAL MEDICAL CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-20",
        "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": "273Y00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Unit",
            "state": "PA",
            "license": "035601",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007568490080",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS CRICHTON",
            "identifier": "1068",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "direct@direct.comemaugh.org",
            "affiliation": "N",
            "address_1": "320 Main St",
            "address_2": "4th Floor",
            "city": "Johnstown",
            "state": "PA",
            "country_code": "US",
            "postal_code": "159011601",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Memorial Medical Center - Crichton Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Memorial Medical Center - Crichton Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Johnstown, PA

Sources for this page

Verify at the official NPI Registry.