NPIMap

Organization Active NPI

Elk Regional Professional Group Inc

  • Rehabilitation Clinic/Center
  • Kersey, PA
National Provider Identifier
1427428796
Registry record updated Sep 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Clinic/CenterTaxonomy code 261QR0400X
Legal business name
ELK REGIONAL PROFESSIONAL GROUP INC
Practice address
174 Skyline Dr
Kersey, PA 15846-9146
Phone
(814) 788-8071
Fax
(814) 788-8073
NPI assigned
Sep 30, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2015

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

Authorized official

Name
Mrs. Rose M Campbell
Title
Board Member
Phone
(814) 788-8000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Clinic/Center 261QR0400X Primary

Addresses

Primary practice location

174 Skyline Dr
Kersey, PA 15846-9146

Mailing address

763 Johnsonburg Rd
Saint Marys, PA 15857-3417

Other names 1

  • Penn Highlands Professional Group Kersey Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040423000700 PA Part B Supplier - Clinic/Group Practice 4486553278 Receives reassigned benefits from 12 practitioners
15 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Kane, PA

Other NPIs on the same Medicare enrollment 15

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

View all 15

National Provider Directory

National Provider Directory
Tax ID family
Elk Regional Professional Group Inc35 organizations share this tax ID, including this one

Other organizations with this tax ID 34

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

View all 34

NPI Registry JSON

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

{
    "created_epoch": "1443571200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1443571200000",
    "number": "1427428796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "763 JOHNSONBURG RD",
            "city": "SAINT MARYS",
            "state": "PA",
            "postal_code": "158573417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "174 SKYLINE DR",
            "city": "KERSEY",
            "state": "PA",
            "postal_code": "158469146",
            "telephone_number": "814-788-8071",
            "fax_number": "814-788-8073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELK REGIONAL PROFESSIONAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-30",
        "last_updated": "2015-09-30",
        "status": "A",
        "authorized_official_last_name": "CAMPBELL",
        "authorized_official_first_name": "ROSE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "BOARD MEMBER",
        "authorized_official_telephone_number": "814-788-8000",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Penn Highlands Professional Group Kersey",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kersey, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2015; 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.