H.B.P.a. Medical Clinic

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

OS-006156-L Issued in PA

Legal business name

H.B.P.A. MEDICAL CLINIC

Practice address

1111 Fire House Rd
Grantville, PA 17028

Phone

(717) 469-2970

Fax

(717) 469-7714

NPI assigned

May 14, 2012

Organization subpart

No

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

Authorized official

Name

Mr. Todd Mostoller

Title

Executive Director

Phone

(717) 469-2970

Specialties & licenses 2

Addresses

Other names 1

• Jeanette Johnston H.B.P.A Medical Clinic Other name

Locations

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

{
    "created_epoch": "1336953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1336953600000",
    "number": "1144589953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 FIREHOUSE RD.",
            "city": "GRANTVILLE",
            "state": "PA",
            "postal_code": "17028",
            "telephone_number": "717-469-2970",
            "fax_number": "717-469-7714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 FIRE HOUSE RD",
            "city": "GRANTVILLE",
            "state": "PA",
            "postal_code": "17028",
            "telephone_number": "717-469-2970",
            "fax_number": "717-469-7714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "H.B.P.A. MEDICAL CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-14",
        "last_updated": "2012-05-14",
        "status": "A",
        "authorized_official_last_name": "MOSTOLLER",
        "authorized_official_first_name": "TODD",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "717-469-2970",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse",
            "state": "PA",
            "license": "RN163-298L",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS-006156-L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jeanette Johnston H.B.P.A Medical Clinic",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Jodi L Cosey, MPT, CAPS
• Karis Deroos, RN
• Hospice for All Seasons
• Annette M Irwin, LMT
• Seasons of Transitions LLC
• Michelle Sholder
• Deborah Tregea, MED

• All providers in Grantville, PA
• Family Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2012; 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.