NPIMap

Organization Active NPI

Geisinger Clinic

  • Family Medicine Physician
  • Danville, PA
National Provider Identifier
1265867113
Registry record updated Mar 31, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
GEISINGER CLINIC
Practice address
604 Continental Blvd
Danville, PA 17821-1022
Phone
(570) 284-4575
Fax
(570) 284-4577
NPI assigned
Sep 11, 2013
Last updated
Mar 31, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2020

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

Authorized official

Name
Cindy L Mull
Title
System Director Enrollments
Phone
(570) 271-6603

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X

Addresses

Primary practice location

604 Continental Blvd
Danville, PA 17821-1022

Mailing address

100 N Academy Ave
Danville, PA 17822-4903
Phone (570) 271-5555

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040130000518 PA Part B Supplier - Clinic/Group Practice 5395657001 Receives reassigned benefits from 5,323 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory
Tax ID family
Geisinger Medical Oncology Lock Haven275 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

425 E 1st St
Bloomsburg, PA 17815
Phone (570) 387-2474

2 Rehab Ln
#150723
Danville, PA 17821
Phone (570) 271-6110

Practitioners & affiliated clinicians

Practitioners 59

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 59

NPI Registry JSON

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

{
    "created_epoch": "1378857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1585612800000",
    "number": "1265867113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N ACADEMY AVE",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178224903",
            "telephone_number": "570-271-5555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "604 CONTINENTAL BLVD",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178211022",
            "telephone_number": "570-284-4575",
            "fax_number": "570-284-4577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEISINGER CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-11",
        "last_updated": "2020-03-31",
        "certification_date": "2020-03-31",
        "status": "A",
        "authorized_official_last_name": "MULL",
        "authorized_official_first_name": "CINDY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "SYSTEM DIRECTOR ENROLLMENTS",
        "authorized_official_telephone_number": "570-271-6603"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Danville, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2020; 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.