NPIMap

Organization Active NPI

St. Joseph Regional Health Network

Doing business as St. Joseph Health Network At Maidencreek

  • Urgent Care Clinic/Center
  • Blandon, PA
National Provider Identifier
1366757973
Registry record updated Aug 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
ST. JOSEPH REGIONAL HEALTH NETWORK
Doing business as
St. Joseph Health Network At Maidencreek
Practice address
108 Plaza Drive
Blandon, PA 19510-9476
Phone
(610) 208-4650
Fax
(610) 916-2787
NPI assigned
Aug 9, 2010
Last updated
Aug 10, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2023

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

Authorized official

Name
Edward Chabalowski
Title
Cfo/VP Finance
Phone
(610) 378-2300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X PA Primary

Addresses

Primary practice location

108 Plaza Drive
Blandon, PA 19510-9476

Mailing address

PO Box 7753
Lancaster, PA 17604-7753

Other names 1

  • St. Joseph Health Network At Maidencreek Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101108000903 PA Part B Supplier - Clinic/Group Practice 1658289517 Receives reassigned benefits from 29 practitioners
2 other NPIs on this enrollment
Practice locations: Blandon, PA; Temple, PA; Strausstown, PA

Other NPIs with the same Medicare PAC ID 2

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

Other NPIs on the same Medicare enrollment 2

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

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
39D2011796St Joseph HLTH Net at Maidencreek Urgent Care108 Plaza Drive, Blandon, PA 19510Certificate of waiverNov 19, 2027

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

108 Plaza Dr
Ste 100
Blandon, PA 19510
Phone (610) 208-4650

Practitioners & affiliated clinicians

Practitioners 57

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 57

NPI Registry JSON

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

{
    "created_epoch": "1281312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691625600000",
    "number": "1366757973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7753",
            "city": "LANCASTER",
            "state": "PA",
            "postal_code": "176047753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 PLAZA DRIVE",
            "city": "BLANDON",
            "state": "PA",
            "postal_code": "195109476",
            "telephone_number": "610-208-4650",
            "fax_number": "610-916-2787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. JOSEPH REGIONAL HEALTH NETWORK",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-09",
        "last_updated": "2023-08-10",
        "certification_date": "2023-08-10",
        "status": "A",
        "authorized_official_last_name": "CHABALOWSKI",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_title_or_position": "CFO/VP FINANCE",
        "authorized_official_telephone_number": "610-378-2300"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "PA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St. Joseph Health Network At Maidencreek",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "St. Joseph Health Network At Maidencreek",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Blandon, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.