NPIMap

Organization Active NPI

Corry Memorial Hospital Association

  • Rural Health Clinic/Center
  • Union City, PA
National Provider Identifier
1255967956
Registry record updated Sep 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
CORRY MEMORIAL HOSPITAL ASSOCIATION
Practice address
101 E High St
Union City, PA 16438-1101
Phone
(814) 664-4641
NPI assigned
Mar 14, 2020
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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Primary
Family Nurse Practitioner 363LF0000X

Addresses

Primary practice location

101 E High St
Union City, PA 16438-1101

Mailing address

965 Shamrock LN
Corry, PA 16407-1196
Phone (814) 664-4641

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20200506001112 PA Part A Provider - Rural Health Clinic 3971581174 Practice locations: Union City, PA
O20201211000131 PA Part B Supplier - Clinic/Group Practice 3971581174 Receives reassigned benefits from 21 practitioners
Practice locations: Union City, PA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1255967956. Details of each certification follow.

Rural health clinic certification: CCN 393446

Legal name
CORRY MEMORIAL HOSPITAL ASSOCIATION
Doing business as
UNION CITY RURAL HEALTH CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Jun 25, 2020
Last certification
Jun 25, 2020
Ownership / control type
2B
Organization structure
CorporationNon-profit
Incorporated
Nov 26, 1894 in PA
Enrollment address
101 E High St
Union City, PA 16438-1101
Related CCNs
391308

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

Other NPIs with the same Medicare PAC ID 6

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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
39D2185109Union City Rural Health Clinic101 E High Street, Union City, PA 16438Certificate of waiverMay 28, 2028

National Provider Directory

National Provider Directory

Locations

101 E High St
Union City, PA 16438
Phone (814) 438-2088

Ownership & related parties

All disclosed owners & managing parties 8

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

NameRoleSinceShare
John M Ferretti Individual Corporate Director Jan 1, 2025
John J Wilson Individual Corporate Director Jan 1, 2025
John J Kalata Individual Corporate Director Jan 1, 2025
Millcreek Health System Organization, Erie, PA Corporation, Non-profit 5% Or Greater Direct Ownership Interest Feb 29, 2016 100%
Operational/Managerial Control Feb 29, 2016 100%
Jasen Diley Individual Corporate Director Jan 1, 2025
Mary L Eckert Individual Corporate Director Jan 1, 2025
Timothy McGahen Individual Corporate OfficerChief Financial Officer Nov 29, 2020
W-2 Managing Employee Dec 9, 2013
Latrisha a Hurd Individual W-2 Managing EmployeePatient Accounting Manager May 4, 2020

Owners & managing parties with NPI records 2

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

Facilities with the same owner 11

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 23

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 23

NPI Registry JSON

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

{
    "created_epoch": "1584144000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758585600000",
    "number": "1255967956",
    "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": "164071196",
            "telephone_number": "814-664-4641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 E HIGH ST",
            "city": "UNION CITY",
            "state": "PA",
            "postal_code": "164381101",
            "telephone_number": "814-664-4641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORRY MEMORIAL HOSPITAL ASSOCIATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-14",
        "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": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Union City, PA

Sources for this page

Verify at the official NPI Registry.