NPIMap

Organization Active NPI

Conemaugh Valley Memorial Hospital

  • Federally Qualified Health Center (FQHC)
  • Johnstown, PA
National Provider Identifier
1396822425
Registry record updated Apr 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
CONEMAUGH VALLEY MEMORIAL HOSPITAL
Practice address
1086 Franklin St
Johnstown, PA 15905-4305
Phone
(814) 534-1821
Fax
(814) 534-1743
NPI assigned
Nov 1, 2006
Last updated
Apr 23, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2008

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

Authorized official

Name
Jean A Dziagwa
Title
Director PFS
Phone
(814) 410-8296

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

1086 Franklin St
Johnstown, PA 15905-4305

Mailing address

1086 Franklin St
Johnstown, PA 15905
Phone (814) 410-8296

Other identifiers 2

IdentifierTypeStateIssuer
1007568490053MedicaidPA
1004907OtherPAGATEWAY EPSDT

Other names 1

  • EPSDT Other name

National Provider Directory

National Provider Directory
Tax ID family
Crichton Center for Adv7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208908800000",
    "number": "1396822425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1086 FRANKLIN ST",
            "city": "JOHNSTOWN",
            "state": "PA",
            "postal_code": "15905",
            "telephone_number": "814-410-8296",
            "fax_number": "814-410-8597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1086 FRANKLIN ST",
            "city": "JOHNSTOWN",
            "state": "PA",
            "postal_code": "159054305",
            "telephone_number": "814-534-1821",
            "fax_number": "814-534-1743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONEMAUGH VALLEY MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2008-04-23",
        "status": "A",
        "authorized_official_last_name": "DZIAGWA",
        "authorized_official_first_name": "JEAN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "DIRECTOR PFS",
        "authorized_official_telephone_number": "814-410-8296"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007568490053",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GATEWAY EPSDT",
            "identifier": "1004907",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "EPSDT",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Johnstown, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2008; 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.