DLP Conemaugh Physician Practices LLC
Organization Active NPI Internal Medicine Physician · Johnstown, PA
NPI 1457767394 · NPPES record last updated Jul 10, 2014
Key facts
- NPI
- 1457767394
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Internal Medicine Physician 207R00000X
- Legal business name
- DLP CONEMAUGH PHYSICIAN PRACTICES LLC
- Practice address
- 1020 Franklin St
Ste 202
Johnstown, PA 15905-4109 - Phone
- (814) 539-7038
- NPI assigned
- Jul 10, 2014
- Organization subpart
- No
Authorized official
- Name
- Jess N Judy
- Title
- President
- Phone
- (615) 920-7000
Other NPIs on the same Medicare enrollment 28
Corporate family (same tax ID) 24
Practitioners 40
-
Natalie Allman, D.O.
-
Jihad Elias Azar, MD
-
Rachel A Bennett, M.D.
-
Jean Berkebile, PMHNP
-
Harrison Daiber, DO
-
Russell John Enedy, PA-C
-
Matthew Fennema, MD
-
Dennis R. Glover, M.D.
-
Kimberly Marie Gorman, DNP, AG-ACNP-BC,
-
Ryan A, Grant, M.D., M.S.
-
Michael L Humphrey, D.O.
-
Imran Ali Idrees, M.D.
-
Christy M James, CRNP
-
Henry N Kesler, MD
-
Adeeb Khalifeh, MD
-
Michaela Ledonne, DO
-
Mackenzie Magley, D.O.
-
Kelli Morgan Manippo, CRNP
-
Erik B Mauzy, OD
-
Megan Beth Mesaros, CNM
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20140915002522 | PA | Part B Supplier - Clinic/Group Practice | 7315166949 |
Receives reassigned benefits from 836 practitioners 28 other NPIs on this enrollment This NPI is an additional NPI on the enrollment |
National Provider Directory
- Tax ID family
- Conemaugh Health Initiatives
Locations
1111 Franklin St
Ste 130
Johnstown, PA 15905
Phone (814) 534-5724
1086 Franklin St
Fl Good
Johnstown, PA 15905
Phone (814) 410-8300
105 Nason Dr
Roaring Spring, PA 16673
Phone (814) 224-2141
1291 N Center Ave
Ste 150A
Somerset, PA 15501
Phone (814) 534-9132
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician |
207R00000X | Yes |
Addresses
Primary practice location
1020 Franklin St
Ste 202
Johnstown, PA 15905-4109
Mailing address
1020 Franklin St
Ste 202
Johnstown, PA 15905-4109
Phone (814) 539-7038
Other names
- CHI PRUCHNIC
Other providers in Johnstown, PA
- DLP Conemaugh Physician Practices LLC
- DLP Conemaugh Physician Practices LLC
- DLP Conemaugh Physician Practices LLC
- DLP Conemaugh Physician Practices LLC
- DLP Conemaugh Physician Practices LLC
- DLP Conemaugh Physician Practices LLC
- DLP Conemaugh Physician Practices LLC
- DLP Conemaugh Physician Practices LLC
- DLP Conemaugh Physician Practices LLC
- DLP Conemaugh Physician Practices LLC
All providers in Johnstown, PA · Internal Medicine Physician in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 10, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.