NPIMap

Organization Active NPI

Dubois Regional Medical Center - Penn Highlands Family Medicine

  • Family Medicine Physician
  • Saint Marys, PA
National Provider Identifier
1194100719
Registry record updated Feb 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
DUBOIS REGIONAL MEDICAL CENTER - PENN HIGHLANDS FAMILY MEDICINE
Practice address
1100 Million Dollar Hwy
Saint Marys, PA 15857-2728
Phone
(814) 781-6758
NPI assigned
Jul 24, 2015
Organization subpart
Yes
Parent organization
PENN HIGHLANDS HEALTHCAREAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 25, 2016

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

Authorized official

Name
Brian Kline
Title
VP & Cfo
Phone
(814) 375-6377

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X

Addresses

Primary practice location

1100 Million Dollar Hwy
Saint Marys, PA 15857-2728

Mailing address

100 Hospital Ave
Du Bois, PA 15801-1440
Phone (814) 375-4200

Other identifiers 1

IdentifierTypeStateIssuer
100774088MedicaidPA

Other names 1

  • Penn Highlands DuBois Doing business as

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
39D1061163Penn Highlands Family Medicine1100 Million Dollar Highway Suite 1, St Marys, PA 15857Certificate of waiverNov 12, 2026

National Provider Directory

National Provider Directory
Tax ID family
Patrick Shilala123 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1437696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1456358400000",
    "number": "1194100719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 HOSPITAL AVE",
            "city": "DU BOIS",
            "state": "PA",
            "postal_code": "158011440",
            "telephone_number": "814-375-4200",
            "fax_number": "814-375-4232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 MILLION DOLLAR HWY",
            "city": "SAINT MARYS",
            "state": "PA",
            "postal_code": "158572728",
            "telephone_number": "814-781-6758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DUBOIS REGIONAL MEDICAL CENTER - PENN HIGHLANDS FAMILY MEDICINE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PENN HIGHLANDS HEALTHCARE",
        "enumeration_date": "2015-07-24",
        "last_updated": "2016-02-25",
        "status": "A",
        "authorized_official_last_name": "KLINE",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "VP & CFO",
        "authorized_official_telephone_number": "814-375-6377"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100774088",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Penn Highlands DuBois",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Saint Marys, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.