NPIMap

Organization Active NPI

Keystone Rural Health Consortia Inc

  • Federally Qualified Health Center (FQHC)
  • Snow Shoe, PA
National Provider Identifier
1174615686
Registry record updated Jan 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
KEYSTONE RURAL HEALTH CONSORTIA INC
Practice address
402 East Sycamore Street
Snow Shoe, PA 16874-0402
Phone
(814) 387-6857
Fax
(814) 387-6870
NPI assigned
Sep 29, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2011

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

Authorized official

Name
Mr. Ronald G Hammersley
Title
Ceo/Administrator
Phone
(814) 486-1115

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary
Primary Care Clinic/Center 261QP2300X

Addresses

Primary practice location

402 East Sycamore Street
Snow Shoe, PA 16874-0402

Mailing address

90 East Second Street
Emporium, PA 15834-1302
Phone (814) 486-1115

Other identifiers 1

IdentifierTypeStateIssuer
1007763960018MedicaidPA

Other names 1

  • Mountaintop Area Medical Center Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 8

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

NPI Registry JSON

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

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1296172800000",
    "number": "1174615686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 EAST SECOND STREET",
            "city": "EMPORIUM",
            "state": "PA",
            "postal_code": "158341302",
            "telephone_number": "814-486-1115",
            "fax_number": "814-486-0404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 EAST SYCAMORE STREET",
            "city": "SNOW SHOE",
            "state": "PA",
            "postal_code": "168740402",
            "telephone_number": "814-387-6857",
            "fax_number": "814-387-6870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEYSTONE RURAL HEALTH CONSORTIA INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-29",
        "last_updated": "2011-01-28",
        "status": "A",
        "authorized_official_last_name": "HAMMERSLEY",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "CEO/ADMINISTRATOR",
        "authorized_official_telephone_number": "814-486-1115",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007763960018",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mountaintop Area Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Snow Shoe, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2011; 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.