NPIMap

Organization Active NPI

Conemaugh Valley Memorial Hospital

Doing business as Memorial Medical Center

  • Emergency Medicine Physician
  • Johnstown, PA
National Provider Identifier
1346200920
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
CONEMAUGH VALLEY MEMORIAL HOSPITAL
Doing business as
Memorial Medical Center
Practice address
1086 Franklin St
Conemaugh Emergency Physicians Group
Johnstown, PA 15905
Phone
(814) 534-9600
NPI assigned
Mar 27, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Edward H Defasquale
Title
Chief Financial Officer
Phone
(814) 534-5031

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X NU Primary

Addresses

Primary practice location

1086 Franklin St
Conemaugh Emergency Physicians Group
Johnstown, PA 15905

Mailing address

551 Main St 3Rd Floor Attn Nicolle
The Informedx Group
Johnstown, PA 15901
Phone (814) 539-5724

Other identifiers 1

IdentifierTypeStateIssuer
1007568490046MedicaidPA

Other names 1

  • Memorial Medical Center Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 92

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 92

NPI Registry JSON

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

{
    "created_epoch": "1143417600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1346200920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "551 MAIN ST 3RD FLOOR ATTN NICOLLE",
            "address_2": "THE INFORMEDX GROUP",
            "city": "JOHNSTOWN",
            "state": "PA",
            "postal_code": "15901",
            "telephone_number": "814-539-5724",
            "fax_number": "814-536-7092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1086 FRANKLIN ST",
            "address_2": "CONEMAUGH EMERGENCY PHYSICIANS GROUP",
            "city": "JOHNSTOWN",
            "state": "PA",
            "postal_code": "15905",
            "telephone_number": "814-534-9600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONEMAUGH VALLEY MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DEFASQUALE",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "814-534-5031",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007568490046",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Memorial Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Johnstown, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.