Active NPI
Corry Memorial Hospital Association
- Critical Access Hospital
- Corry, PA
National Provider Identifier
1255788014
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Critical Access Hospital
- License
- 03400101
- 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
- Organization subpart
- No
Authorized official
NPPES NPI Registry- Name
- Timothy Scott McGahen
- Title
- Administrator/Cfo
- Phone
- (814) 664-4641
Other NPIs with the same Medicare PAC ID 6
Corporate family (same tax ID) 5
Practitioners 48
-
Joshua Stelmack, DO
-
John E Balmer Jr., D.O.
-
Amy Farris, DO
-
Paul W Heberle, D.O.
-
Yuriy Iskrenko, DO
-
Neeru Agarwal, DO
-
Amy J Bahl, CRNP
-
Carleen Cho, MD
-
Bryan Colligan, DO
-
Lori Mae Dulabon, DO
-
Kristen Lynn Heard, DPM
-
Korinda Messenger, CNM
-
Adnan Barazi, MD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20160816000171 | PA | Part B Supplier - Hospital Department(S) | 3971581174 |
Receives reassigned benefits from 9 practitioners Practice locations: Corry, PA |
National Provider Directory
- Tax ID family
- Corry Mem Hosp Assn
Specialties & licenses 1
NPPES NPI Registry| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Critical Access Hospital | 282NC0060X | 03400101 | PA | Primary |
Addresses
NPPES NPI RegistryPrimary 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
NPPES NPI Registry- corry memorial hospital er physician group
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Sep 23, 2025.
{
"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
- Corry Medical Services, Inc.
- Corry Medical Services, Inc.
- Corry Medical Services, Inc.
- Corry Memorial Hosital
- Corry Memorial Hospital Association
- Corry Memorial Hospital Association
- Corry Memorial Hospital Association
- Corry Memorial Hospital Association
- Corry Memorial Hospital Association
- Corry Memorial Hospital Association
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.