NPIMap

Organization Active NPI

Bruce M Lidston and Allen B Ettenger Partners

Doing business as Huntingdon Pediatric Associates

  • Pediatric Adolescent Medicine Physician
  • Huntingdon, PA
National Provider Identifier
1285664953
Registry record updated Jul 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X
License
MD016074E Issued in PA
Legal business name
BRUCE M LIDSTON AND ALLEN B ETTENGER PARTNERS
Doing business as
Huntingdon Pediatric Associates
Practice address
1227 Warm Springs Ave Ste 301
Huntingdon, PA 16652-2300
Phone
(814) 643-0531
Fax
(814) 643-6637
NPI assigned
Jul 5, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2008

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

Authorized official

Name
Dr. Bruce M Lidston, M.D.
Title
Partner
Phone
(814) 643-0531

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Adolescent Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2080A0000X MD016074E PA Primary

Addresses

Primary practice location

1227 Warm Springs Ave Ste 301
Huntingdon, PA 16652-2300

Mailing address

1227 Warm Springs Ave Ste 301
Huntingdon, PA 16652-2300
Phone (814) 643-0531

Other identifiers 3

IdentifierTypeStateIssuer
0006768160004MedicaidPA
1007685540002MedicaidPA
0010017640004MedicaidPA

Other names 1

  • Huntingdon Pediatric Associates Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Bruce M Lidston and Allen B Ettenger Partners2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

NPI Registry JSON

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214870400000",
    "number": "1285664953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1227 WARM SPRINGS AVE STE 301",
            "city": "HUNTINGDON",
            "state": "PA",
            "postal_code": "166522300",
            "telephone_number": "814-643-0531",
            "fax_number": "814-643-6637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1227 WARM SPRINGS AVE STE 301",
            "city": "HUNTINGDON",
            "state": "PA",
            "postal_code": "166522300",
            "telephone_number": "814-643-0531",
            "fax_number": "814-643-6637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRUCE M LIDSTON AND ALLEN B ETTENGER PARTNERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-05",
        "last_updated": "2008-07-01",
        "status": "A",
        "authorized_official_last_name": "LIDSTON",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "814-643-0531",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "PA",
            "license": "MD016074E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0006768160004",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007685540002",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0010017640004",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Huntingdon Pediatric Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Huntingdon, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.