NPIMap

Organization Active NPI

Centre Medical and Surgical Associates, P.C.

  • Clinical Medical Laboratory
  • State College, PA
National Provider Identifier
1396708160
Registry record updated Jun 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
000709 Issued in PA
Legal business name
CENTRE MEDICAL AND SURGICAL ASSOCIATES, P.C.
Practice address
1850 E Park Ave
Suite 205
State College, PA 16803-6706
Phone
(814) 234-7800
Fax
(814) 234-8068
NPI assigned
Apr 11, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2010

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

Authorized official

Name
John J. McQueary
Title
Coo/Administrative Director
Phone
(814) 234-4753

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X 000709 PA Primary

Addresses

Primary practice location

1850 E Park Ave
Suite 205
State College, PA 16803-6706

Mailing address

1850 E Park Ave
Suite 205
State College, PA 16803-6706
Phone (814) 234-7800

Other identifiers 2

IdentifierTypeStateIssuer
398341OtherPAHIGHMARK BLUE SHIELD
1007679310019MedicaidPA

Other names 1

  • CMSA Medical Laboratory Other name

National Provider Directory

National Provider Directory

Locations

143 Hospital Dr
Ste 205
State College, PA 16803
Phone (814) 234-6848

NPI Registry JSON

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

{
    "created_epoch": "1144713600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1275955200000",
    "number": "1396708160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1850 E PARK AVE",
            "address_2": "SUITE 205",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168036706",
            "telephone_number": "814-234-7800",
            "fax_number": "814-234-8068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1850 E PARK AVE",
            "address_2": "SUITE 205",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168036706",
            "telephone_number": "814-234-7800",
            "fax_number": "814-234-8068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRE MEDICAL AND SURGICAL ASSOCIATES, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-11",
        "last_updated": "2010-06-08",
        "status": "A",
        "authorized_official_last_name": "MCQUEARY",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "COO/ADMINISTRATIVE DIRECTOR",
        "authorized_official_telephone_number": "814-234-4753"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "PA",
            "license": "000709",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "398341",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007679310019",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CMSA Medical Laboratory",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in State College, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2010; 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.