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Organization Active NPI

DLP Conemaugh Physician Practices LLC

Doing business as Conemaugh Physician Practices - Ebensburg Primary Care

  • Family Medicine Physician
  • Ebensburg, PA
National Provider Identifier
1376959213
Registry record updated Feb 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
DLP CONEMAUGH PHYSICIAN PRACTICES LLC
Doing business as
Conemaugh Physician Practices - Ebensburg Primary Care
Practice address
861 Hills PLZ Ste 140
Ebensburg, PA 15931-4211
Phone
(814) 471-9005
Fax
(814) 471-9007
NPI assigned
Jul 10, 2014
Last updated
Feb 19, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2024

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

Authorized official

Name
Monica Bowman
Title
President
Phone
(615) 920-7000

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU
Nurse Practitioner 363L00000X NU
Family Medicine Physician 207Q00000X NU Primary
Internal Medicine Physician 207R00000X NU
Pediatrics Physician 208000000X NU

Addresses

Primary practice location

861 Hills PLZ Ste 140
Ebensburg, PA 15931-4211

Mailing address

1100 W High St
Ebensburg, PA 15931-1706
Phone (814) 472-7933

Other practice location 1

139 Cook Rd Ste 140
Ebensburg, PA 15931
Phone (814) 727-9334

Other practice location 2

1100 W High St
Ebensburg, PA 15931-1706
Phone (814) 472-7933

Other names 1

  • Conemaugh Physician Practices - Ebensburg Primary Care Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140915002522 PA Part B Supplier - Clinic/Group Practice 7315166949 Receives reassigned benefits from 836 practitioners
28 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment

Other NPIs on the same Medicare enrollment 28

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

View all 28

National Provider Directory

National Provider Directory
Tax ID family
Conemaugh Health Initiatives25 organizations share this tax ID, including this one

Other organizations with this tax ID 24

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

View all 24

Locations

139 Cook Rd
Ste 140
Ebensburg, PA 15931
Phone (814) 727-9334

Practitioners & affiliated clinicians

Practitioners 35

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 35

NPI Registry JSON

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

{
    "created_epoch": "1404950400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708300800000",
    "number": "1376959213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 W HIGH ST",
            "city": "EBENSBURG",
            "state": "PA",
            "postal_code": "159311706",
            "telephone_number": "814-472-7933",
            "fax_number": "814-472-2301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "861 HILLS PLZ STE 140",
            "city": "EBENSBURG",
            "state": "PA",
            "postal_code": "159314211",
            "telephone_number": "814-471-9005",
            "fax_number": "814-471-9007"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "139 Cook Rd Ste 140",
            "address_purpose": "LOCATION",
            "city": "Ebensburg",
            "state": "PA",
            "postal_code": "15931",
            "country_code": "US",
            "telephone_number": "814-727-9334",
            "fax_number": "814-472-2301",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1100 W High St",
            "address_purpose": "LOCATION",
            "city": "Ebensburg",
            "state": "PA",
            "postal_code": "159311706",
            "country_code": "US",
            "telephone_number": "814-472-7933",
            "fax_number": "814-472-2301",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "DLP CONEMAUGH PHYSICIAN PRACTICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-10",
        "last_updated": "2024-02-19",
        "certification_date": "2024-02-19",
        "status": "A",
        "authorized_official_last_name": "BOWMAN",
        "authorized_official_first_name": "MONICA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "615-920-7000"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Conemaugh Physician Practices - Ebensburg Primary Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ebensburg, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.