NPIMap

Organization Active NPI

Geisinger Wyoming Valley Medical Center

  • Clinic/Center
  • Wilkes Barre, PA
National Provider Identifier
1447538640
Registry record updated Sep 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
GEISINGER WYOMING VALLEY MEDICAL CENTER
Practice address
620 Baltimore Dr
Wilkes Barre, PA 18702-7959
Phone
(570) 271-5555
NPI assigned
Jul 22, 2011
Last updated
Sep 29, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2020

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

Authorized official

Name
Cindy L Mull
Title
System Director
Phone
(570) 271-6603

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

620 Baltimore Dr
Wilkes Barre, PA 18702-7959

Mailing address

100 N Academy Ave
Danville, PA 17822-4903
Phone (570) 271-5555

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040901000618 PA Part A Provider - Hospital 5092780023 21 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Wilkes Barre, PA; Wilkes-Barre, PA; Wilkes -Barre, PA; Dallas, PA; Dickson City, PA; Forty Fort, PA; Mountain Top, PA; Mountaintop, PA…

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1447538640. Details of each certification follow.

Hospital certification: CCN 390270

Legal name
GEISINGER WYOMING VALLEY MEDICAL CENTER
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Apr 20, 1981
Last certification
Sep 4, 2025
Beds
356 (317 certified)
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
Feb 2, 1976 in PA
Enrollment address
1000 East Mountain Drive
GWV Op Surgery
Wilkes Barre, PA 18711-0027
Other Hospital Practice Location
Hospital subgroups
General, Acute care

Other NPIs on the same Medicare enrollment 19

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

View all 19

Care Compare: Hospital

Medicare Care Compare
Listed as
Geisinger Wyoming Valley Medical CenterCCN 390270 · All quality measures
Overall star rating
4 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Tax ID family
Geisinger Medic 30324 organizations share this tax ID, including this one

Other organizations with this tax ID 23

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

View all 23

Ownership & related parties

All disclosed owners & managing parties 9

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Terry Gilliland Individual Corporate Officer Mar 1, 2025
Daniel J Gaydon Individual Corporate OfficerAssociate Vice President, Finance Jan 1, 2026
W-2 Managing Employee Jan 1, 2026
William Schultz Individual Corporate OfficerVice President & Cfo Jan 1, 2026
W-2 Managing Employee Jan 1, 2026
Jeffrey a Jacobson Individual Corporate Officer Jan 1, 2019
Chris Holcombe Individual Corporate Officer Jan 1, 2017
Benjamin K Chu Individual Corporate Director Jan 1, 2020
Virginia McGregor Individual Corporate Officer Jan 1, 2017
Jason Mitchell Individual Corporate Officer Jan 1, 2026
Megan Brosious Individual Corporate Officer Mar 1, 2025

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Affiliated clinicians 1,567

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 1,567

NPI Registry JSON

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

{
    "created_epoch": "1311292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1601337600000",
    "number": "1447538640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N ACADEMY AVE",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178224903",
            "telephone_number": "570-271-5555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 BALTIMORE DR",
            "city": "WILKES BARRE",
            "state": "PA",
            "postal_code": "187027959",
            "telephone_number": "570-271-5555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEISINGER WYOMING VALLEY MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-22",
        "last_updated": "2020-09-29",
        "certification_date": "2020-09-29",
        "status": "A",
        "authorized_official_last_name": "MULL",
        "authorized_official_first_name": "CINDY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "SYSTEM DIRECTOR",
        "authorized_official_telephone_number": "570-271-6603"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilkes Barre, PA

Sources for this page

Verify at the official NPI Registry.