NPIMap

Organization Active NPI

Upmc Altoona

Doing business as Williamsburg Family Practice

  • General Acute Care Hospital
  • Williamsburg, PA
National Provider Identifier
1437100765
Registry record updated Sep 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
012801 Issued in PA
Legal business name
UPMC ALTOONA
Doing business as
Williamsburg Family Practice
Practice address
306 Plum St
Williamsburg, PA 16693-1116
Phone
(814) 832-3405
Fax
(814) 832-3811
NPI assigned
May 12, 2006
Last updated
Sep 5, 2013By the provider in NPPES
Organization subpart
Yes
Parent organization
UPMC ALTOONAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 5, 2013

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

Authorized official

Name
Mr. Jerry Murray
Title
Ceo
Phone
(814) 889-2223

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X 012801 PA Primary

Addresses

Primary practice location

306 Plum St
Williamsburg, PA 16693-1116

Mailing address

306 Plum St
Williamsburg, PA 16693-1116
Phone (814) 832-3405

Other names 1

  • Williamsburg Family Practice Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040406001118 PA Part B Supplier - Clinic/Group Practice 8426962465 Receives reassigned benefits from 30 practitioners
Practice locations: Williamsburg, PA

Other NPIs with the same Medicare PAC ID 6

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Part of
Pathology Altoona Hosp

Locations

501 Howard Ave
Ste F2
Altoona, PA 16601
Phone (814) 889-2020

306 Plum St
Williamsburg, PA 16693
Phone (814) 832-3405

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Encompass Health Rehabilitation Hospital of AltoonaAltoona, PA, CCN 393040 Hospital 5% Or Greater Indirect Ownership Interest (15%) Nov 1, 2009

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 72

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 72

NPI Registry JSON

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

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1378339200000",
    "number": "1437100765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "306 PLUM ST",
            "city": "WILLIAMSBURG",
            "state": "PA",
            "postal_code": "166931116",
            "telephone_number": "814-832-3405",
            "fax_number": "814-832-3811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "306 PLUM ST",
            "city": "WILLIAMSBURG",
            "state": "PA",
            "postal_code": "166931116",
            "telephone_number": "814-832-3405",
            "fax_number": "814-832-3811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UPMC ALTOONA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "UPMC ALTOONA",
        "enumeration_date": "2006-05-12",
        "last_updated": "2013-09-05",
        "status": "A",
        "authorized_official_last_name": "MURRAY",
        "authorized_official_first_name": "JERRY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "814-889-2223",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "PA",
            "license": "012801",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Williamsburg Family Practice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Williamsburg, PA

Sources for this page

Verify at the official NPI Registry.