NPIMap

Organization Active NPI

Conneaut Valley Health Center Podiatry

  • Primary Podiatric Medicine Podiatrist
  • Conneautville, PA
National Provider Identifier
1356473094
Registry record updated Apr 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Podiatric Medicine PodiatristTaxonomy code 213EP1101X
License
SC004174R Issued in PA
Legal business name
CONNEAUT VALLEY HEALTH CENTER PODIATRY
Practice address
906 Washington St
Conneautville, PA 16406-7138
Phone
(814) 373-2276
Fax
(814) 587-2918
NPI assigned
Mar 9, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2014

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

Authorized official

Name
Mr. Michael C Downing, FACHE, CMPE
Title
Ceo
Phone
(814) 373-2449

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Podiatric Medicine PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213EP1101X SC004174R PA Primary

Addresses

Primary practice location

906 Washington St
Conneautville, PA 16406-7138

Mailing address

1009 Water St
Second Floor
Meadville, PA 16335-3465
Phone (814) 373-2449

Other identifiers 1

IdentifierTypeStateIssuer
0007230030001MedicaidPA

National Provider Directory

National Provider Directory
Tax ID family
Conneaut Valley Health Center Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

1009 Water St
Ste 2
Meadville, PA 16335

NPI Registry JSON

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

{
    "created_epoch": "1173398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1397433600000",
    "number": "1356473094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1009 WATER ST",
            "address_2": "SECOND FLOOR",
            "city": "MEADVILLE",
            "state": "PA",
            "postal_code": "163353465",
            "telephone_number": "814-373-2449",
            "fax_number": "814-373-3050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "906 WASHINGTON ST",
            "city": "CONNEAUTVILLE",
            "state": "PA",
            "postal_code": "164067138",
            "telephone_number": "814-373-2276",
            "fax_number": "814-587-2918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONNEAUT VALLEY HEALTH CENTER PODIATRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-09",
        "last_updated": "2014-04-14",
        "status": "A",
        "authorized_official_last_name": "DOWNING",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "814-373-2449",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "FACHE, CMPE"
    },
    "taxonomies": [
        {
            "code": "213EP1101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "PA",
            "license": "SC004174R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0007230030001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Conneautville, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2014; 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.