NPIMap

Organization Active NPI

Lock Haven Medical Professionals PC

Doing business as Haven Orthopedic and Sports Medicine

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Lock Haven, PA
National Provider Identifier
1457310252
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X
Legal business name
LOCK HAVEN MEDICAL PROFESSIONALS PC
Doing business as
Haven Orthopedic and Sports Medicine
Practice address
24 Cree Dr
Lock Haven, PA 17745-2639
Phone
(570) 893-5330
NPI assigned
Mar 21, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Gary Newsome
Title
Senior Vice President
Phone
(570) 893-5330

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X Primary

Addresses

Primary practice location

24 Cree Dr
Lock Haven, PA 17745-2639

Mailing address

330 Franklin Road,
#135A-501
Brentwood, TN 37027
Phone (615) 309-3300

Other identifiers 1

IdentifierTypeStateIssuer
1013815860001MedicaidPA

Other names 1

  • Haven Orthopedic and Sports Medicine Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Community Medical Care Associates2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1142899200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1457310252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 FRANKLIN ROAD,",
            "address_2": "#135A-501",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "37027",
            "telephone_number": "615-309-3300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 CREE DR",
            "city": "LOCK HAVEN",
            "state": "PA",
            "postal_code": "177452639",
            "telephone_number": "570-893-5330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOCK HAVEN MEDICAL PROFESSIONALS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "NEWSOME",
        "authorized_official_first_name": "GARY",
        "authorized_official_title_or_position": "SENIOR VICE PRESIDENT",
        "authorized_official_telephone_number": "570-893-5330"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1013815860001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Haven Orthopedic and Sports Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lock Haven, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.