Conneaut Valley Health Center Inc.

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

License

OS011018L Issued in PA

Legal business name

CONNEAUT VALLEY HEALTH CENTER INC.

Doing business as

CONNEAUT LAKE HEALTH CENTER

Practice address

10926 Highway 18
Conneaut Lake, PA 16316-3526

Phone

(814) 382-0446

Fax

(814) 382-7386

NPI assigned

Oct 27, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Michael Downing

Title

Ceo

Phone

(814) 373-2449

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• CONNEAUT LAKE HEALTH CENTER Doing business as

Locations

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

{
    "created_epoch": "1161907200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1397088000000",
    "number": "1427133248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1034 GROVE ST",
            "city": "MEADVILLE",
            "state": "PA",
            "postal_code": "163352945",
            "telephone_number": "814-373-2449",
            "fax_number": "814-373-3050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10926 HIGHWAY 18",
            "city": "CONNEAUT LAKE",
            "state": "PA",
            "postal_code": "163163526",
            "telephone_number": "814-382-0446",
            "fax_number": "814-382-7386"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONNEAUT VALLEY HEALTH CENTER INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-27",
        "last_updated": "2014-04-10",
        "status": "A",
        "authorized_official_last_name": "DOWNING",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "814-373-2449",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "PA",
            "license": "OS011018L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BC/BS",
            "identifier": "191386",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0007230030012",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CONNEAUT LAKE HEALTH CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Nour Majid Bussard, LPC
• Casey James Chapman, DC
• Kimberly Marie Conley, LCSW
• Conneaut Lake Area Ambulance Service
• Conneaut Lake Chiropractic, PC
• Mindy Curtiss, CERT HEALTH COACH
• Ryan Scott Evans, D.O.
• Carrie Elizabeth Flemming
• Paul Thomas Foulk, DMD
• Thomas Carl Fox, DMD

• Rural Health Clinic/Center in Conneaut Lake, PA
• Providers in Conneaut Lake, PA by specialty
• Rural Health Clinic/Center in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2014; 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.