NPIMap

Organization Active NPI

North Penn Comprehensive Health Services

Doing business as Lawrenceville Laurel Health Center

  • Federally Qualified Health Center (FQHC)
  • Lawrenceville, PA
National Provider Identifier
1326148164
Registry record updated Jun 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
NORTH PENN COMPREHENSIVE HEALTH SERVICES
Doing business as
Lawrenceville Laurel Health Center
Practice address
32 E Lawrence Rd
Lawrenceville Health Center
Lawrenceville, PA 16929
Phone
(570) 827-0125
Fax
(570) 827-0129
NPI assigned
Sep 22, 2006
Last updated
Jun 8, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2022

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

Authorized official

Name
Angela M. Vanzile
Title
Credentialing Coordinator
Phone
(570) 662-1945

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary
Physician Assistant 363A00000X
Nurse Practitioner 363L00000X
Dentist 122300000X
Family Medicine Physician 207Q00000X

Addresses

Primary practice location

32 E Lawrence Rd
Lawrenceville Health Center
Lawrenceville, PA 16929

Mailing address

6A Riverside PLZ
Blossburg, PA 16912-1137
Phone (570) 662-1945

Other identifiers 1

IdentifierTypeStateIssuer
1000011720039MedicaidPA

Other names 1

  • Lawrenceville Laurel Health Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040416000152 PA Part B Supplier - Clinic/Group Practice 0446245880 Receives reassigned benefits from 67 practitioners
14 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Mansfield, PA; Westfield, PA; Wellsboro, PA; Troy, PA; Towanda, PA; Blossburg, PA; Elkland, PA; Lawrenceville, PA…
O20050517000268 PA Part A Provider - Federally Qualified Health Center (FQHC) 0446245880 Practice locations: Lawrenceville, PA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1326148164. Details of each certification follow.

Federally qualified health center certification: CCN 391895

Legal name
NORTH PENN COMPREHENSIVE HEALTH SERVICES
Doing business as
LAWRENCEVILLE LAUREL HEALTH CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Sep 24, 1998
Last certification
Sep 24, 1998
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Aug 10, 1972 in PA
Enrollment address
32 E Lawrence Rd
Lawrenceville, PA 16929-8801
Related CCNs
391845

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 13

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 13

Other NPIs on the same Medicare enrollment 14

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

View all 14

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
39D0878284Laurel Health Center - Lawrenceville32 East Lawrence Road, Lawrenceville, PA 16929Provider-performed microscopyDec 17, 2027

National Provider Directory

National Provider Directory
Tax ID family
North Penn Comp Health14 organizations share this tax ID, including this one

Other organizations with this tax ID 13

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

View all 13

Locations

40 W Wellsboro St
Mansfield, PA 16933
Phone (570) 662-1945

45 Mud Creek Rd
Troy, PA 16947
Phone (570) 297-3746

Ownership & related parties

All disclosed owners & managing parties 13

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

NameRoleSinceShare
Scott D Myers Individual Corporate DirectorDirector Apr 1, 2025
John Dennis Murray Individual Corporate DirectorBoard Member May 18, 1989
Donna R Wilson Individual Corporate DirectorBoard Member - Secretary Jul 1, 1998
Sean Sember Individual Corporate DirectorBoard Member Jul 1, 2021
James a Nobles Individual Corporate OfficerCeo Mar 5, 2018
Thomas Thompson Individual Corporate DirectorBoard Member Jul 1, 2022
Jody Thomas Individual Corporate DirectorBoard Member Jul 1, 2019
Megan Wells-Williams Individual Corporate DirectorBoard Member Jul 1, 2021
Kelly Irwin Individual Corporate DirectorBoard Member Jul 1, 2023
Ronald M Gilbert Individual Corporate OfficerChief Financial Officer Jul 1, 2018 100%
W-2 Managing EmployeeChief Financial Officer Jul 1, 2018 100%
Kimberly Johns Individual Corporate DirectorBoard Member Jul 1, 2022
Kristopher Kaufman Individual Corporate DirectorBoard Member Jul 1, 2022
Jason Krise Individual Corporate DirectorBoard Member - Chairman Jul 1, 2021

Practitioners & affiliated clinicians

Practitioners 15

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 15

NPI Registry JSON

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1654646400000",
    "number": "1326148164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6A RIVERSIDE PLZ",
            "city": "BLOSSBURG",
            "state": "PA",
            "postal_code": "169121137",
            "telephone_number": "570-662-1945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32 E LAWRENCE RD",
            "address_2": "LAWRENCEVILLE HEALTH CENTER",
            "city": "LAWRENCEVILLE",
            "state": "PA",
            "postal_code": "16929",
            "telephone_number": "570-827-0125",
            "fax_number": "570-827-0129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH PENN COMPREHENSIVE HEALTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-22",
        "last_updated": "2022-06-08",
        "certification_date": "2022-06-08",
        "status": "A",
        "authorized_official_last_name": "VANZILE",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "570-662-1945"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1000011720039",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lawrenceville Laurel Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lawrenceville, PA

Sources for this page

Verify at the official NPI Registry.