NPIMap

Organization Active NPI

DLP Conemaugh Physician Practices LLC

Doing business as Conemaugh Physician Group Internists

  • Internal Medicine Physician
  • Johnstown, PA
National Provider Identifier
1487060455
Registry record updated Jul 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
DLP CONEMAUGH PHYSICIAN PRACTICES LLC
Doing business as
Conemaugh Physician Group Internists
Practice address
1 Tech Park Dr
Ste. 1120
Johnstown, PA 15901-2515
Phone
(814) 475-8700
Fax
(814) 475-8795
NPI assigned
Jul 10, 2014
Last updated
Jul 10, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2014

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

Authorized official

Name
Jess N Judy
Title
President
Phone
(615) 920-7000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X NU Primary

Addresses

Primary practice location

1 Tech Park Dr
Ste. 1120
Johnstown, PA 15901-2515

Mailing address

1 Tech Park Dr
Ste. 1120
Johnstown, PA 15901-2515
Phone (814) 475-8700

Other names 1

  • CONEMAUGH PHYSICIAN GROUP INTERNISTS Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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

Other NPIs on the same Medicare enrollment 28

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

View all 28

National Provider Directory

National Provider Directory
Tax ID family
Conemaugh Health Initiatives25 organizations share this tax ID, including this one

Other organizations with this tax ID 24

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

View all 24

Locations

1086 Franklin St
Bldg E
Johnstown, PA 15905
Phone (814) 534-9104

Practitioners & affiliated clinicians

Practitioners 19

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 19

NPI Registry JSON

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

{
    "created_epoch": "1404950400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1404950400000",
    "number": "1487060455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 TECH PARK DR",
            "address_2": "STE. 1120",
            "city": "JOHNSTOWN",
            "state": "PA",
            "postal_code": "159012515",
            "telephone_number": "814-475-8700",
            "fax_number": "814-475-8795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 TECH PARK DR",
            "address_2": "STE. 1120",
            "city": "JOHNSTOWN",
            "state": "PA",
            "postal_code": "159012515",
            "telephone_number": "814-475-8700",
            "fax_number": "814-475-8795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DLP CONEMAUGH PHYSICIAN PRACTICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-10",
        "last_updated": "2014-07-10",
        "status": "A",
        "authorized_official_last_name": "JUDY",
        "authorized_official_first_name": "JESS",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "615-920-7000"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CONEMAUGH PHYSICIAN GROUP INTERNISTS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Johnstown, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.