NPIMap

Organization Active NPI

Heritage Valley Medical Group, Inc.

  • Family Medicine Physician
  • Ellwood City, PA
National Provider Identifier
1427417591
Registry record updated Feb 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
HERITAGE VALLEY MEDICAL GROUP, INC.
Practice address
271 State Route 288
Ellwood City, PA 16117-3055
Phone
(724) 773-4681
NPI assigned
Feb 18, 2016
Last updated
Feb 18, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2016

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

Authorized official

Name
Norman F Mitry
Title
President & Ceo
Phone
(724) 773-4776

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X

Addresses

Primary practice location

271 State Route 288
Ellwood City, PA 16117-3055

Mailing address

271 State Route 288
Ellwood City, PA 16117-3055
Phone (724) 773-4681

Other identifiers 1

IdentifierTypeStateIssuer
0015654460023MedicaidPA

Other names 1

  • Heritage Valley Convenient Care Other name

National Provider Directory

National Provider Directory
Tax ID family
Heritage Valleymedical Group Inc92 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

271 State Route 288
Ellwood City, PA 16117
Phone (724) 773-4681

NPI Registry JSON

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

{
    "created_epoch": "1455753600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1455753600000",
    "number": "1427417591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "271 STATE ROUTE 288",
            "city": "ELLWOOD CITY",
            "state": "PA",
            "postal_code": "161173055",
            "telephone_number": "724-773-4681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "271 STATE ROUTE 288",
            "city": "ELLWOOD CITY",
            "state": "PA",
            "postal_code": "161173055",
            "telephone_number": "724-773-4681"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HERITAGE VALLEY MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-18",
        "last_updated": "2016-02-18",
        "status": "A",
        "authorized_official_last_name": "MITRY",
        "authorized_official_first_name": "NORMAN",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "724-773-4776"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0015654460023",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Heritage Valley Convenient Care",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Ellwood City, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2016; 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.