NPIMap

Organization Active NPI

Corry Memorial Hospital Association

  • Critical Access Hospital
  • Corry, PA
National Provider Identifier
1255788014
Registry record updated Sep 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
License
03400101 Issued in PA
Legal business name
CORRY MEMORIAL HOSPITAL ASSOCIATION
Practice address
965 Shamrock LN
Corry, PA 16407-9121
Phone
(814) 664-4641
NPI assigned
May 20, 2016
Last updated
Sep 23, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2025

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

Authorized official

Name
Timothy Scott McGahen
Title
Administrator/Cfo
Phone
(814) 664-4641

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital 282NC0060X 03400101 PA Primary

Addresses

Primary practice location

965 Shamrock LN
Corry, PA 16407-9121

Mailing address

965 Shamrock LN
Corry, PA 16407-9121
Phone (814) 664-4641

Other names 1

  • corry memorial hospital er physician group Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160816000171 PA Part B Supplier - Hospital Department(S) 3971581174 Receives reassigned benefits from 9 practitioners
Practice locations: Corry, PA

Other NPIs with the same Medicare PAC ID 6

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

National Provider Directory

National Provider Directory
Tax ID family
Corry Memorial Hosp Assoc6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

Practitioners & affiliated clinicians

Practitioners 34

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 34

NPI Registry JSON

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

{
    "created_epoch": "1463702400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758585600000",
    "number": "1255788014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "965 SHAMROCK LN",
            "city": "CORRY",
            "state": "PA",
            "postal_code": "164079121",
            "telephone_number": "814-664-4641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "965 SHAMROCK LN",
            "city": "CORRY",
            "state": "PA",
            "postal_code": "164079121",
            "telephone_number": "814-664-4641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORRY MEMORIAL HOSPITAL ASSOCIATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-20",
        "last_updated": "2025-09-23",
        "certification_date": "2025-09-23",
        "status": "A",
        "authorized_official_last_name": "MCGAHEN",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "ADMINISTRATOR/CFO",
        "authorized_official_telephone_number": "814-664-4641"
    },
    "taxonomies": [
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "PA",
            "license": "03400101",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "corry memorial hospital er physician group",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Sep 23, 2025; 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.