NPIMap

Organization Active NPI

North Penn Comprehensive Health Services

  • Federally Qualified Health Center (FQHC)
  • Towanda, PA
National Provider Identifier
1114776994
Registry record updated May 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
NORTH PENN COMPREHENSIVE HEALTH SERVICES
Practice address
410 Main St Ste 102
Towanda, PA 18848-1865
Phone
(570) 266-5882
NPI assigned
May 15, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 15, 2024

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

Authorized official

Name
Ronald Meryl Gilbert
Title
Chief Financial Officer
Phone
(570) 828-3869

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

410 Main St Ste 102
Towanda, PA 18848-1865

Mailing address

40 W Wellsboro St
Mansfield, PA 16933-1411
Phone (570) 662-1945

Other names 1

  • Towanda Laurel Health Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040416000152 PA Part B Supplier - Clinic/Group Practice 0446245880 Receives reassigned benefits from 67 practitioners
14 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Mansfield, PA; Westfield, PA; Wellsboro, PA; Troy, PA; Towanda, PA; Blossburg, PA; Elkland, PA; Lawrenceville, PA…
O20240903002532 PA Part A Provider - Federally Qualified Health Center (FQHC) 0446245880 Practice locations: Towanda, PA

Federally qualified health center certification: CCN D31017

Legal name
NORTH PENN COMPREHENSIVE HEALTH SERVICES
Doing business as
TOWANDA LAUREL HEALTH CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Aug 15, 2024
Last certification
Aug 15, 2024
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Aug 10, 1972 in PA
Enrollment address
410 Main St
Ste 102
Towanda, PA 18848-1865

All disclosed owners & managing parties 14

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

NameRoleSinceShare
Scott D Myers Individual Corporate DirectorBoard Member Apr 1, 2025
John Dennis Murray Individual Corporate DirectorBoard Member Jul 1, 1986
Donna R Wilson Individual Corporate DirectorBoard Member - Secretary Jun 1, 2013
Sean Sember Individual Corporate DirectorBoard Member Jul 1, 2021
James a Nobles Individual Corporate OfficerCeo Mar 5, 2021
W-2 Managing EmployeeCeo Mar 5, 2018
Thomas Thompson Individual Corporate DirectorBoard Member - Treasurer Jul 1, 2022
Jody Thomas Individual Corporate DirectorBoard Member - Vice Chairperson Jul 1, 2019
Megan Wells-Williams Individual Corporate DirectorBoard Member Jul 1, 2021
Kelly Irwin Individual Corporate DirectorBoard Member Jul 1, 2023
Ronald M Gilbert Individual W-2 Managing EmployeeChief Financial Officer Jul 1, 2018 100%
Kimberly Johns Individual Corporate DirectorBoard Member Jun 29, 2022
Kristopher Kaufman Individual Corporate DirectorBoard Member Jul 1, 2022
Darla Bortz Individual Corporate DirectorBoard Member Apr 1, 2025
Jason Krise Individual Corporate DirectorBoard Member - Chairman Jul 1, 2021

National Provider Directory

National Provider Directory
Tax ID family
North Penn Comp Health14 organizations share this tax ID, including this one

Other organizations with this tax ID 13

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

View all 13

Other NPIs on the same Medicare enrollment 14

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 14

Other NPIs with the same Medicare PAC ID 13

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

View all 13

Practitioners 45

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 45

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
39D2308284Towanda Laurel Health Center410 Main St, Suite 102, Towanda, PA 18848Certificate of waiverJul 24, 2028

NPI Registry JSON

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

{
    "created_epoch": "1715731200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715731200000",
    "number": "1114776994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 W WELLSBORO ST",
            "city": "MANSFIELD",
            "state": "PA",
            "postal_code": "169331411",
            "telephone_number": "570-662-1945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 MAIN ST STE 102",
            "city": "TOWANDA",
            "state": "PA",
            "postal_code": "188481865",
            "telephone_number": "570-266-5882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH PENN COMPREHENSIVE HEALTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-15",
        "last_updated": "2024-05-15",
        "certification_date": "2024-05-15",
        "status": "A",
        "authorized_official_last_name": "GILBERT",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "MERYL",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "570-828-3869"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Towanda Laurel Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Towanda, PA

Sources for this page

Verify at the official NPI Registry.