NPIMap

Organization Active NPI

Pennsylvania Department of Human Services

Doing business as Danville State Hospital

  • Psychiatric Hospital
  • Danville, PA
National Provider Identifier
1457334336
Registry record updated Oct 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric HospitalTaxonomy code 283Q00000X
Legal business name
PENNSYLVANIA DEPARTMENT OF HUMAN SERVICES
Doing business as
Danville State Hospital
Practice address
50 Kirkbride Dr
Danville, PA 17821-8630
Phone
(570) 271-4510
Fax
(570) 271-4514
NPI assigned
Nov 23, 2005
Last updated
Oct 4, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2021

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

Authorized official

Name
Kathy Light
Title
Administrator
Phone
(717) 772-2518

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital 283Q00000X NU Primary
Institutional Pharmacy 3336I0012X NU
Long Term Care Pharmacy 3336L0003X NU

Addresses

Primary practice location

50 Kirkbride Dr
Danville, PA 17821-8630

Mailing address

50 Kirkbride Dr
Danville, PA 17821-8630
Phone (570) 271-4510

Other identifiers 1

IdentifierTypeStateIssuer
100308518MedicaidPA

Other names 1

  • Danville State Hospital Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040116001002 PA Part B Supplier - Clinic/Group Practice 0547168064 Receives reassigned benefits from 11 practitioners
Practice locations: Danville, PA
O20061102000351 PA Part A Provider - Hospital 0547168064 Practice locations: Danville, PA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1457334336. Details of each certification follow.

Hospital certification: CCN 394004

Legal name
PENNSYLVANIA DEPARTMENT OF HUMAN SERVICES
Doing business as
DANVILLE STATE HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Psychiatric
Participating since
Jul 1, 1966
Last certification
Dec 7, 2023
Beds
161
Ownership / control type
State
Organization structure
GovernmentNon-profit
Enrollment address
50 Kirkbride Dr
Danville, PA 17821-8630
Main/Primary Hospital Location
Hospital subgroups
Other

Other NPIs with the same Medicare PAC ID 9

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Danville State HospitalCCN 394004 · All quality measures
Type
Psychiatric
Ownership
Government - State
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
No

National Provider Directory

National Provider Directory
Tax ID family
Polk Center16 organizations share this tax ID, including this one

Other organizations with this tax ID 15

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

View all 15

Locations

625 Forester St
Harrisburg, PA 17120

Ownership & related parties

All disclosed owners & managing parties 8

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

NameRoleSinceShare
Tricia Carpenter Individual W-2 Managing EmployeeManagement Analysist Supervisor May 15, 2023
Pennsylvania Department of Human Services Organization, Danville, PA Operational/Managerial Control Dec 31, 2011
Joseph Caulfield Individual W-2 Managing EmployeeCoo Feb 4, 2013
Operational/Managerial ControlCoo Feb 4, 2013
Myra Lynn McSwain Kamran Individual Contracted Managing EmployeeCmo Feb 25, 2019
W-2 Managing EmployeeCmo Feb 25, 2019
Cheryl Tressler Individual W-2 Managing EmployeeCpie Oct 10, 2023
Operational/Managerial ControlCpie Oct 10, 2023
Diane Dalberto Individual W-2 Managing EmployeeCne Aug 11, 2014
Operational/Managerial ControlCne Aug 11, 2014
Kathy Light Individual W-2 Managing Employee Jul 1, 2016
Thomas Burk Individual W-2 Managing EmployeeCeo Sep 24, 2004
Operational/Managerial ControlCeo Sep 24, 2004

Owners & managing parties with NPI records 10

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

All facility ownership & control disclosures 6

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

FacilityTypeRoleSince
Warren State HospitalNorth Warren, PA, CCN 394016 Hospital Operational/Managerial Control Jan 1, 1966
Wernersville State HospitalWernersville, PA, CCN 394014 Hospital Operational/Managerial Control Feb 10, 2007
Norristown State HospitalNorristown, PA, CCN 394001 Hospital Operational/Managerial Control Jul 12, 1966
Pennsylvania Department of Human ServicesClarks Summit, PA, CCN 394012 Hospital Operational/Managerial Control Dec 24, 2014
Torrance State HospitalTorrance, PA, CCN 394026 Hospital Operational/Managerial Control (100%) Jul 1, 1966
South Mountain Restoration CenterSouth Mountain, PA, CCN 395583 Skilled nursing facility Adp of the SNF Sep 15, 2025

Owned or controlled facilities with NPI records 6

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

Facilities with the same owner 5

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 21

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 21

NPI Registry JSON

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

{
    "created_epoch": "1132704000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1633305600000",
    "number": "1457334336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 KIRKBRIDE DR",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178218630",
            "telephone_number": "570-271-4510",
            "fax_number": "570-271-4514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 KIRKBRIDE DR",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178218630",
            "telephone_number": "570-271-4510",
            "fax_number": "570-271-4514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENNSYLVANIA DEPARTMENT OF HUMAN SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-23",
        "last_updated": "2021-10-04",
        "certification_date": "2021-10-04",
        "status": "A",
        "authorized_official_last_name": "LIGHT",
        "authorized_official_first_name": "KATHY",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "717-772-2518"
    },
    "taxonomies": [
        {
            "code": "283Q00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Hospital",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "3336I0012X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Institutional Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100308518",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Danville State Hospital",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Danville State Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Danville, PA

Sources for this page

Verify at the official NPI Registry.