NPIMap

Organization Active NPI

Blair Gastroenterology Associates

  • Gastroenterology Physician
  • Altoona, PA
National Provider Identifier
1295761666
Registry record updated Jun 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
Legal business name
BLAIR GASTROENTEROLOGY ASSOCIATES
Practice address
810 Valley View Blvd
Altoona, PA 16602-6342
Phone
(814) 946-5469
Fax
(814) 946-4970
NPI assigned
Jun 25, 2006
Last updated
Jun 16, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2016

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

Authorized official

Name
Dr. Ralph D McKibbin, M.D.NPI 1467486035
Title
Shareholder
Phone
(814) 946-5469

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X MD439868 PA
Gastroenterology Physician 207RG0100X NU Primary

Addresses

Primary practice location

810 Valley View Blvd
Altoona, PA 16602-6342

Mailing address

810 Valley View Blvd
Altoona, PA 16602-6342
Phone (814) 946-5469

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041201000706 PA Part B Supplier - Clinic/Group Practice 4284699257 Receives reassigned benefits from 31 practitioners
Practice locations: Everett, PA; Ebensburg, PA; Altoona, PA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 32

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 32

NPI Registry JSON

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

{
    "created_epoch": "1151193600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1466035200000",
    "number": "1295761666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "810 VALLEY VIEW BLVD",
            "city": "ALTOONA",
            "state": "PA",
            "postal_code": "166026342",
            "telephone_number": "814-946-5469",
            "fax_number": "814-946-4970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 VALLEY VIEW BLVD",
            "city": "ALTOONA",
            "state": "PA",
            "postal_code": "166026342",
            "telephone_number": "814-946-5469",
            "fax_number": "814-946-4970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLAIR GASTROENTEROLOGY ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-25",
        "last_updated": "2016-06-16",
        "status": "A",
        "authorized_official_last_name": "MCKIBBIN",
        "authorized_official_first_name": "RALPH",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "SHAREHOLDER",
        "authorized_official_telephone_number": "814-946-5469",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "PA",
            "license": "MD439868",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Altoona, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2016; 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.