NPIMap

Organization Active NPI

Cornerstone Family Health, PC

  • Family Medicine Physician
  • Williamsport, PA
National Provider Identifier
1376523449
Registry record updated Nov 18, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
CORNERSTONE FAMILY HEALTH, PC
Practice address
1205 Grampian Blvd
Suite 3
Williamsport, PA 17701-1978
Phone
(570) 326-4118
Fax
(570) 326-5533
NPI assigned
Jan 17, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2009

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

Authorized official

Name
Dr. James Redka, M.D.NPI 1548240773
Title
President
Phone
(570) 326-4118

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

1205 Grampian Blvd
Suite 3
Williamsport, PA 17701-1978

Mailing address

1205 Grampian Blvd
Suite 3
Williamsport, PA 17701-1978
Phone (570) 326-4118

Other identifiers 6

IdentifierTypeStateIssuer
020833OtherPAAMERIHEALTH
020833OtherPAHIGHMARK BLUE SHIELD
85252OtherPAAETNA
0006325900001MedicaidPA
1002OtherPAFIRST PRIORITY HEALTH
C74266OtherPAPALMETTO/MC RAILROAD

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1137456000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1258502400000",
    "number": "1376523449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1205 GRAMPIAN BLVD",
            "address_2": "SUITE 3",
            "city": "WILLIAMSPORT",
            "state": "PA",
            "postal_code": "177011978",
            "telephone_number": "570-326-4118",
            "fax_number": "570-326-5533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1205 GRAMPIAN BLVD",
            "address_2": "SUITE 3",
            "city": "WILLIAMSPORT",
            "state": "PA",
            "postal_code": "177011978",
            "telephone_number": "570-326-4118",
            "fax_number": "570-326-5533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORNERSTONE FAMILY HEALTH, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-17",
        "last_updated": "2009-11-18",
        "status": "A",
        "authorized_official_last_name": "REDKA",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "570-326-4118",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH",
            "identifier": "020833",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "020833",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "85252",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0006325900001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST PRIORITY HEALTH",
            "identifier": "1002",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO/MC RAILROAD",
            "identifier": "C74266",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsport, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2009; 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.