NPIMap

Organization Active NPI

Elk Regional Health Center, Inc.

  • General Practice Physician
  • Ridgway, PA
National Provider Identifier
1487874640
Registry record updated Sep 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
ELK REGIONAL HEALTH CENTER, INC.
Practice address
104 Metoxet Street
Ridgway, PA 15853
Phone
(814) 788-5555
Fax
(814) 788-5655
NPI assigned
Apr 27, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2013

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

Authorized official

Name
Jamie L Yount
Title
Administrator
Phone
(814) 788-8615

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X Primary
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X

Addresses

Primary practice location

104 Metoxet Street
Ridgway, PA 15853

Mailing address

763 Johnsonburg Road
Erhc Med Express
St. Marys, PA 15857
Phone (814) 788-8580

Other identifiers 1

IdentifierTypeStateIssuer
1007292600030MedicaidPA

Other names 1

  • Med Express Other name

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1177632000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1378166400000",
    "number": "1487874640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "763 JOHNSONBURG ROAD",
            "address_2": "ERHC MED EXPRESS",
            "city": "ST. MARYS",
            "state": "PA",
            "postal_code": "15857",
            "telephone_number": "814-788-8580",
            "fax_number": "814-788-8042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 METOXET STREET",
            "city": "RIDGWAY",
            "state": "PA",
            "postal_code": "15853",
            "telephone_number": "814-788-5555",
            "fax_number": "814-788-5655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELK REGIONAL HEALTH CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-27",
        "last_updated": "2013-09-03",
        "status": "A",
        "authorized_official_last_name": "YOUNT",
        "authorized_official_first_name": "JAMIE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "814-788-8615"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007292600030",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Med Express",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Ridgway, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2013; 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.