NPIMap

Organization Active NPI

Community Medical Center

Doing business as Geisinger Community Medical Center

  • Endocrinology, Diabetes & Metabolism Physician
  • Scranton, PA
National Provider Identifier
1306439856
Registry record updated Jun 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
Legal business name
COMMUNITY MEDICAL CENTER
Doing business as
Geisinger Community Medical Center
Practice address
3 W Olive St
Scranton, PA 18508-2572
Phone
(570) 961-3823
Fax
(570) 207-5988
NPI assigned
Feb 16, 2021
Last updated
Jun 29, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
GEISINGER COMMUNITY MEDICAL CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 29, 2023

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 9

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X
Endocrinology, Diabetes & Metabolism Physician 207RE0101X Primary
Gastroenterology Physician 207RG0100X
Otolaryngology Physician 207Y00000X
Neurology Physician 2084N0400X
Clinical Neurophysiology Physician 2084N0600X
Clinic/Center 261Q00000X
General Acute Care Hospital 282N00000X
Obesity and Weight Management Nutrition Registered Dietitian 133VN1201X

Addresses

Primary practice location

3 W Olive St
Scranton, PA 18508-2572

Mailing address

100 N Academy Ave
Danville, PA 17822-4903
Phone (570) 271-6144

Other names 1

  • Geisinger Community Medical Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080114000318 PA Part A Provider - Hospital 9335104371 14 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Scranton, PA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1306439856. Details of each certification follow.

Hospital certification: CCN 390001

Legal name
COMMUNITY MEDICAL CENTER
Doing business as
GEISINGER COMMUNITY MEDICAL CENTER
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Aug 15, 2025
Beds
294 (275 certified)
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
Sep 20, 1962 in PA
Enrollment address
1800 Mulberry St
Scranton, PA 18510-2369
Main/Primary Hospital Location
Hospital subgroups
General

Other NPIs on the same Medicare enrollment 9

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Hospital

Medicare Care Compare
Listed as
Geisinger-Community Medical CenterCCN 390001 · All quality measures
Overall star rating
2 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Part of
Trauma Surgeons CMC

Ownership & related parties

All disclosed owners & managing parties 11

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Terry Gilliland Individual Corporate Officer May 6, 2024
Community Medial Center Healthcare System Organization, Scranton, PA 5% Or Greater Direct Ownership Interest Jan 31, 1983
Daniel J Gaydon Individual Corporate OfficerAssociate Vice President, Finance Jan 1, 2026
W-2 Managing Employee Jan 1, 2026
William Schultz Individual Corporate OfficerVice President & Cfo Jan 1, 2026
W-2 Managing Employee Jan 1, 2026
Allan Vandermark Individual W-2 Managing EmployeeAvp, Revenue Management Jun 17, 2026
Jeffrey a Jacobson Individual Corporate Director Apr 1, 2019
Chris Holcombe Individual Corporate Officer Jan 31, 2017
Will Xenakis Individual W-2 Managing EmployeeSenior Director Credentialing Jun 17, 2026
Benjamin K Chu Individual Corporate Director Aug 1, 2023
Virginia McGregor Individual Corporate Director Dec 29, 2006
Megan Brosious Individual Corporate Officer Mar 1, 2025

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Affiliated clinicians 1,231

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 1,231

NPI Registry JSON

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

{
    "created_epoch": "1613433600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687996800000",
    "number": "1306439856",
    "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": "570-271-6144",
            "fax_number": "570-271-6578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 W OLIVE ST",
            "city": "SCRANTON",
            "state": "PA",
            "postal_code": "185082572",
            "telephone_number": "570-961-3823",
            "fax_number": "570-207-5988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY MEDICAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GEISINGER COMMUNITY MEDICAL CENTER",
        "enumeration_date": "2021-02-16",
        "last_updated": "2023-06-29",
        "certification_date": "2023-06-29",
        "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": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0600X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Clinical Neurophysiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "133VN1201X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Obesity and Weight Management",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Geisinger Community Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Scranton, PA

Sources for this page

Verify at the official NPI Registry.