NPIMap

Organization Active NPI

Corry Medical Services, Inc.

  • Surgery Physician
  • Corry, PA
National Provider Identifier
1215003199
Registry record updated Jan 31, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
CORRY MEDICAL SERVICES, INC.
Practice address
108 West Smith Street
Corry, PA 16407-1152
Phone
(814) 664-7037
Fax
(814) 664-7039
NPI assigned
Nov 24, 2006
Last updated
Jan 31, 2011By the provider in NPPES
Organization subpart
Yes
Parent organization
CORRY MEDICAL SERVICES, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 31, 2011

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

Authorized official

Name
Mr. Michael Heller
Title
Cfo
Phone
(814) 664-4641

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X NU
Surgery Physician 208600000X NU Primary
Urology Physician 208800000X NU

Addresses

Primary practice location

108 West Smith Street
Corry, PA 16407-1152

Mailing address

PO Box 76642
Cleveland, OH 44101-6500
Phone (814) 664-4641

Other identifiers 2

IdentifierTypeStateIssuer
CA9106OtherPARAILROAD MEDICARE
1007733850026MedicaidPA

National Provider Directory

National Provider Directory
Part of
Susan M Kaufman D O

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": "1164326400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1296432000000",
    "number": "1215003199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 76642",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441016500",
            "telephone_number": "814-664-4641",
            "fax_number": "814-663-9900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 WEST SMITH STREET",
            "city": "CORRY",
            "state": "PA",
            "postal_code": "164071152",
            "telephone_number": "814-664-7037",
            "fax_number": "814-664-7039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORRY MEDICAL SERVICES, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CORRY MEDICAL SERVICES, INC.",
        "enumeration_date": "2006-11-24",
        "last_updated": "2011-01-31",
        "status": "A",
        "authorized_official_last_name": "HELLER",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "814-664-4641",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CA9106",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007733850026",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Corry, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 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.