NPIMap

Organization Active NPI

Mount Nittany Medical Center Health Services Inc

  • Clinic/Center
  • State College, PA
National Provider Identifier
1245418334
Registry record updated May 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
MOUNT NITTANY MEDICAL CENTER HEALTH SERVICES INC
Practice address
120 Radnor Rd Ste 100
State College, PA 16801-7970
Phone
(814) 231-7868
Fax
(814) 238-4169
NPI assigned
Jan 31, 2008
Last updated
May 14, 2026By 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, 2026

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

Authorized official

Name
Bryan Roach
Title
Cfo
Phone
(814) 234-6148

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X PA Primary

Addresses

Primary practice location

120 Radnor Rd Ste 100
State College, PA 16801-7970

Mailing address

155 Wellness Way
State College, PA 16803-6702
Phone (814) 231-7000

Other names 1

  • Mount Nittany Center For Wound Care 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

Locations

120 Radnor Rd
State College, PA 16801
Phone (814) 231-7128

NPI Registry JSON

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

{
    "created_epoch": "1201737600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1778716800000",
    "number": "1245418334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 WELLNESS WAY",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168036702",
            "telephone_number": "814-231-7000",
            "fax_number": "814-231-7098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 RADNOR RD STE 100",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168017970",
            "telephone_number": "814-231-7868",
            "fax_number": "814-238-4169"
        }
    ],
    "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": "2008-01-31",
        "last_updated": "2026-05-14",
        "certification_date": "2026-05-14",
        "status": "A",
        "authorized_official_last_name": "ROACH",
        "authorized_official_first_name": "BRYAN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "814-234-6148"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "PA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mount Nittany Center For Wound Care",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Mount Nittany Center For Wound Care",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in State College, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2026; 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.