Andrew Thomas Matthew Colebank, DO

Key facts

NPI: 1346937620
Entity type: Individual (NPI type 1)
Primary specialty: Student in an Organized Health Care Education/Training Program 390200000X
Practice address: 120 Locust Ave Ext
Mount Morris, PA 15349-1355
Phone: (724) 324-9001
Fax: (724) 324-9005
NPI assigned: Apr 18, 2023
Sex: Male
Sole proprietor: No

Medicare participation

Medicare fee-for-service enrollment: Enrolled in PA
Eligible to order & refer: Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
I20231001000045	PA	Order and Referring Only - Family Practice Practitioner - Family Practice	3072967652

National Provider Directory

Medicare enrollment (NPD): Yes
Credentials: Doctor of Osteopathy

Interoperability endpoints

Direct secure messaging: andrew.colebank.p12@direct.cornerstonecare.nextgenshare.com

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Student in an Organized Health Care Education/Training Program	390200000X		PA	Yes

Addresses

Primary practice location

120 Locust Ave Ext
Mount Morris, PA 15349-1355

Mailing address

120 Locust Ave Ext
Mount Morris, PA 15349-1355
Phone (724) 324-9001

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Apr 18, 2023.

{
    "created_epoch": "1681776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681776000000",
    "number": "1346937620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 LOCUST AVE EXT",
            "city": "MOUNT MORRIS",
            "state": "PA",
            "postal_code": "153491355",
            "telephone_number": "724-324-9001",
            "fax_number": "724-324-9005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 LOCUST AVE EXT",
            "city": "MOUNT MORRIS",
            "state": "PA",
            "postal_code": "153491355",
            "telephone_number": "724-324-9001",
            "fax_number": "724-324-9005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLEBANK",
        "first_name": "ANDREW",
        "middle_name": "THOMAS MATTHEW",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-04-18",
        "last_updated": "2023-04-18",
        "certification_date": "2023-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "PA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Morris, PA

All providers in Mount Morris, PA · Student in an Organized Health Care Education/Training Program in Pennsylvania

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 18, 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.
Order and Referring (CMS).
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.