Bedford Family Wellness LLC
Organization Active NPI Primary Care Clinic/Center · Bedford, PA
NPI 1306328174 · NPPES record last updated Jun 2, 2023
Key facts
- NPI
- 1306328174
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Primary Care Clinic/Center 261QP2300X
- Legal business name
- BEDFORD FAMILY WELLNESS LLC
- Practice address
- 5157 Business 220 Ste 1
Bedford, PA 15522-7770 - Phone
- (814) 623-8414
- Fax
- (814) 623-6668
- NPI assigned
- Aug 29, 2018
- Organization subpart
- No
Authorized official
- Name
- Jennifer Fitzsimmons, CRNP
- Title
- Owner
- Phone
- (814) 623-8414
Practitioners 2
-
Jennifer Beth Woodring, CRNP
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 39D2238859 | Bedford Family Wellness LLC | Certificate of waiver | Oct 6, 2027 |
| 39D2287293 | Bedford Family Wellness LLC | Certificate of waiver | Aug 10, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20201123000018 | PA | Part B Supplier - Clinic/Group Practice | 5799196812 |
Receives reassigned benefits from 2 practitioners Practice locations: Ebensburg, PA; Bedford, PA |
National Provider Directory
Locations
5157 Business 220
Bedford, PA 15522
Phone (814) 623-2961
5157 Business 220
#1
Bedford, PA 15522
Phone (814) 623-8414
501 W High St
Ste 1
Ebensburg, PA 15931
Phone (814) 846-5213
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Care Clinic/Center | 261QP2300X | Yes |
Addresses
Primary practice location
5157 Business 220 Ste 1
Bedford, PA 15522-7770
Mailing address
5157 Business 220 Ste 1
Bedford, PA 15522-7770
Phone (814) 623-8414
Other practice location 1
501 W High St
Ebensburg, PA 15931-1583
Phone (814) 623-8414
Other providers in Bedford, PA
- Bedford Area School District
- Bedford Dental Health Center LLC
- Bedford Dental Professional Corp
- Bedford Dermatology
- Bedford Family Chiropractic Center, P.C.
- Bedford Medical Center
- Bedford Regional Foot & Ankle Care, LLC
- Bedford SNF Healthcare LLC
- Bedford Somerset Developmental and Behavioral Health Services
- Bedford Wellness Center LLC
All providers in Bedford, PA · Primary Care Clinic/Center in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 2, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.