NPIMap

Organization Active NPI

Elk Regional Health Center

Doing business as Cameron County Rural Health Center

  • Rural Health Clinic/Center
  • Emporium, PA
National Provider Identifier
1245858109
Registry record updated Jul 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
ELK REGIONAL HEALTH CENTER
Doing business as
Cameron County Rural Health Center
Practice address
416 N Broad St
Emporium, PA 15834-1402
Phone
(814) 486-2202
Fax
(814) 486-0973
NPI assigned
Jul 8, 2020
Last updated
Jul 8, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
PENN HIGHLANDS HEALTHCAREAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 8, 2020

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

Authorized official

Name
Bradley Joseph Chapman
Title
President/Auth Official
Phone
(814) 788-8550

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X
Internal Medicine Physician 207R00000X
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

416 N Broad St
Emporium, PA 15834-1402

Mailing address

763 Johnsonburg Rd
Saint Marys, PA 15857-3417
Phone (814) 375-4200

Other identifiers 1

IdentifierTypeStateIssuer
100729260MedicaidPA

Other names 1

  • CAMERON COUNTY RURAL HEALTH CENTER Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20201021000280 PA Part A Provider - Rural Health Clinic 7517870512 Practice locations: Emporium, PA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1245858109. Details of each certification follow.

Rural health clinic certification: CCN 393448

Legal name
ELK REGIONAL HEALTH CENTER
Doing business as
PENN HIGHLANDS ELK
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Feb 6, 2020
Last certification
Jan 8, 2026
Ownership / control type
2B
Most recent change of ownership
Nov 1, 2020 (1 total)
Organization structure
CorporationNon-profit
Incorporated
Feb 24, 1920 in PA
Enrollment address
416 N Broad St
Cameron County Rural Health Center
Emporium, PA 15834-1402
Related CCNs
390086

Facilities connected through Provider of Services related, parent or unit certification numbers.

View all 28

Other NPIs with the same Medicare PAC ID 9

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Anesthesiology Andrew K9 organizations share this tax ID, including this one
Part of
Penn Highlands Healthcare

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 23

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Douglas Winner Individual Corporate OfficerSystem Chief Financial Officer Aug 12, 2024
Jourdan D Strishock Individual W-2 Managing EmployeeCompliance Director Aug 1, 2021
Russell E Cameron Individual Corporate OfficerChief Medical Information Officer Jul 1, 2016
Penn Highlands Healthcare, Inc. Organization, Du Bois, PA Non-profit Other Jul 1, 2013
Robert W O'Leary Individual Corporate DirectorBoard Member Jul 1, 2021
Trina L Johnson Individual Corporate OfficerChief Medical Officer Oct 21, 2022
Edward Yahner Individual Corporate DirectorBoard Member Jul 1, 2025
Joanne Ryan Individual Corporate DirectorBoard Member Jul 1, 2022
David Lezzer Individual Corporate DirectorBoard Member Jul 1, 2021
James E Devlin Individual Corporate DirectorBoard Member Jul 1, 2022
Carlyn Belczyk Individual Corporate DirectorBoard Member Oct 1, 2021
Samuel Lewis Individual Corporate DirectorBoard Member Feb 1, 2021
Richard L Pfingstler Individual Corporate DirectorBoard Member Jul 1, 2021
Donald E Conrad Individual Corporate DirectorBoard Member Jul 1, 2021
Scott H Foradora Individual Corporate DirectorBoard Member Jul 1, 2020
Mark Norman Individual Corporate OfficerChief Operating Officer Jul 1, 2016
W-2 Managing Employee Jul 1, 2016
William H Young Individual Corporate DirectorBoard Member Jul 1, 2021
Mark McGinley Individual Corporate DirectorBoard Member Oct 1, 2021
James B Ryan Individual Corporate DirectorBoard Member Jul 1, 2020
John S Sutika Individual Corporate DirectorBoard Member Jul 1, 2025
Brian S Kline Individual Corporate OfficerChief Financial Officer Jul 1, 2024
W-2 Managing Employee Jul 1, 2024
Steven M Fontaine Individual Corporate OfficerChief Executive Officer Jul 1, 2016
Julianne Peer Individual Corporate OfficerPresident Oct 21, 2023
W-2 Managing Employee Oct 21, 2023

Owners & managing parties with NPI records 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 4

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Penn Highlands Community NursesSaint Marys, PA, CCN 397028 Home health agency Operational/Managerial Control Jul 1, 2013
Penn Highlands Community NursesClearfield, PA, CCN 397091 Home health agency Operational/Managerial Control Jul 1, 2013
Penn Highlands Community NursesSaint Marys, PA, CCN 391562 Hospice Operational/Managerial Control Jul 1, 2013
Penn Highlands Community NursesClearfield, PA, CCN 391542 Hospice Operational/Managerial Control Jun 1, 2017

Owned or controlled facilities with NPI records 4

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Change-of-ownership history 1

DateEventCounterparty
Nov 1, 2020 Change of OwnershipThis provider was the buyer Penn Highlands DuboisCCN 393448, PA, NPI 1649427071

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

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": "1594166400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1594166400000",
    "number": "1245858109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "763 JOHNSONBURG RD",
            "city": "SAINT MARYS",
            "state": "PA",
            "postal_code": "158573417",
            "telephone_number": "814-375-4200",
            "fax_number": "814-775-4232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "416 N BROAD ST",
            "city": "EMPORIUM",
            "state": "PA",
            "postal_code": "158341402",
            "telephone_number": "814-486-2202",
            "fax_number": "814-486-0973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELK REGIONAL HEALTH CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PENN HIGHLANDS HEALTHCARE",
        "enumeration_date": "2020-07-08",
        "last_updated": "2020-07-08",
        "certification_date": "2020-07-08",
        "status": "A",
        "authorized_official_last_name": "CHAPMAN",
        "authorized_official_first_name": "BRADLEY",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "PRESIDENT/AUTH OFFICIAL",
        "authorized_official_telephone_number": "814-788-8550"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100729260",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CAMERON COUNTY RURAL HEALTH CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Emporium, PA

Sources for this page

Verify at the official NPI Registry.