NPIMap

Organization Active NPI

Slippery Rock Family Medicine Center P.C.

  • Specialist
  • Slippery Rock, PA
National Provider Identifier
1295750123
Registry record updated Aug 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
MD046378L Issued in PA
Legal business name
SLIPPERY ROCK FAMILY MEDICINE CENTER P.C.
Practice address
565 Kelly Blvd
Slippery Rock, PA 16057-1155
Phone
(724) 794-4023
Fax
(724) 794-3675
NPI assigned
Jul 13, 2006
Last updated
Aug 7, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2008

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

Authorized official

Name
Dr. Michael A McDonald, M.D.NPI 1679563530
Title
Owner
Phone
(724) 794-4023

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X MD046378L PA Primary

Addresses

Primary practice location

565 Kelly Blvd
Slippery Rock, PA 16057-1155

Mailing address

565 Kelly Blvd
Slippery Rock, PA 16057-1155
Phone (724) 794-4023

Other identifiers 2

IdentifierTypeStateIssuer
364635OtherPAHIGHMARK BCBS
1007574700001MedicaidPA

National Provider Directory

National Provider Directory

Locations

565 Kelly Blvd
Slippery Rock, PA 16057
Phone (723) 794-4023

Practitioners & affiliated clinicians

Practitioners 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1218067200000",
    "number": "1295750123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "565 KELLY BLVD",
            "city": "SLIPPERY ROCK",
            "state": "PA",
            "postal_code": "160571155",
            "telephone_number": "724-794-4023",
            "fax_number": "724-794-3675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "565 KELLY BLVD",
            "city": "SLIPPERY ROCK",
            "state": "PA",
            "postal_code": "160571155",
            "telephone_number": "724-794-4023",
            "fax_number": "724-794-3675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SLIPPERY ROCK FAMILY MEDICINE CENTER P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-13",
        "last_updated": "2008-08-07",
        "status": "A",
        "authorized_official_last_name": "MCDONALD",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "724-794-4023",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "PA",
            "license": "MD046378L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BCBS",
            "identifier": "364635",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007574700001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Slippery Rock, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 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.