NPIMap

Organization Active NPI

Mount Nittany Medical Center Health Services Inc

  • Family Medicine Physician
  • Spring Mills, PA
National Provider Identifier
1164691499
Registry record updated May 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
568674 Issued in PA
Legal business name
MOUNT NITTANY MEDICAL CENTER HEALTH SERVICES INC
Practice address
4570 Penns Valley Rd
Ste 1
Spring Mills, PA 16875-8500
Phone
(814) 422-8873
Fax
(814) 422-8860
NPI assigned
Feb 20, 2008
Last updated
May 14, 2008By the provider in NPPES
Organization subpart
Yes
Parent organization
MOUNT NITTANY MEDICAL CENTER HEALTH SERVICES INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 14, 2008

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

Authorized official

Name
Mr. Scott Allen Kaufman
Title
Director of Corporate Compliance an
Phone
(814) 234-6147

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 568674 PA Primary

Addresses

Primary practice location

4570 Penns Valley Rd
Ste 1
Spring Mills, PA 16875-8500

Mailing address

4570 Penns Valley Rd
Ste 1
Spring Mills, PA 16875-8500
Phone (814) 422-8873

Other names 1

  • Penns Valley Area Medical Center PC Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081021000240 PA Part B Supplier - Clinic/Group Practice 8426136797 Receives reassigned benefits from 471 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: State College, PA; Reedsville, PA; Port Matilda, PA; Allentown, PA; Altoona, PA; Bellefonte, PA; Du Bois, PA; Girard, PA…

Other NPIs on the same Medicare enrollment 3

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

National Provider Directory

National Provider Directory
Part of
Mount Nittany Med Ctr Inc

NPI Registry JSON

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

{
    "created_epoch": "1203465600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210723200000",
    "number": "1164691499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4570 PENNS VALLEY RD",
            "address_2": "STE 1",
            "city": "SPRING MILLS",
            "state": "PA",
            "postal_code": "168758500",
            "telephone_number": "814-422-8873",
            "fax_number": "814-422-8860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4570 PENNS VALLEY RD",
            "address_2": "STE 1",
            "city": "SPRING MILLS",
            "state": "PA",
            "postal_code": "168758500",
            "telephone_number": "814-422-8873",
            "fax_number": "814-422-8860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNT NITTANY MEDICAL CENTER HEALTH SERVICES INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MOUNT NITTANY MEDICAL CENTER HEALTH SERVICES INC",
        "enumeration_date": "2008-02-20",
        "last_updated": "2008-05-14",
        "status": "A",
        "authorized_official_last_name": "KAUFMAN",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_middle_name": "ALLEN",
        "authorized_official_title_or_position": "DIRECTOR OF CORPORATE COMPLIANCE AN",
        "authorized_official_telephone_number": "814-234-6147",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "568674",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Penns Valley Area Medical Center PC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Spring Mills, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.