FC of Pennsylvania Inc

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

771605 Issued in PA

Legal business name

FC OF PENNSYLVANIA INC

Practice address

4813 Jonestown Rd Ste 201
Harrisburg, PA 17109-1749

Phone

(469) 673-6666

Fax

(214) 445-3994

NPI assigned

Nov 18, 2005

Organization subpart

No

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

Authorized official

Name

Robert Parker

Title

Cco

Phone

(214) 445-3773

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Intrepid USA Healthcare Services Doing business as

Electronic endpoints 1

Locations

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

{
    "created_epoch": "1132272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1667865600000",
    "number": "1356323992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14841 DALLAS PKWY STE 625",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752547641",
            "telephone_number": "214-445-3750",
            "fax_number": "214-445-3950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4813 JONESTOWN RD STE 201",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171091749",
            "telephone_number": "469-673-6666",
            "fax_number": "214-445-3994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FC OF PENNSYLVANIA INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-18",
        "last_updated": "2022-11-08",
        "certification_date": "2022-11-08",
        "status": "A",
        "authorized_official_last_name": "PARKER",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "CCO",
        "authorized_official_telephone_number": "214-445-3773"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "PA",
            "license": "771605",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1010078870001",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "Ability Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "100 N 6th St Ste 900A",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554031516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Intrepid USA Healthcare Services",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Intrepid USA Healthcare Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Epauline Faubert, LCSW
• Jacob Faust
• Kathryn Fayman
• Salman Fazal, M.D.
• Karen Fazio, O.T.
• Alicia Marie Federico
• Tatiana Fedotova
• Stacy Lynn Feldman
• Todd Matthew Felix, MD
• James Felty, MA, LPC, CAADC

• Home Health Agency in Harrisburg, PA
• Providers in Harrisburg, PA by specialty
• Home Health Agency in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2022; 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.