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Organization Active NPI

Vibra Hospital of Mahoning Valley LLC

Doing business as Vibra Hospital of Mahoning Valley

  • Long Term Care Hospital
  • Boardman, OH
National Provider Identifier
1528203049
Registry record updated Dec 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care HospitalTaxonomy code 282E00000X
License
1428 Issued in OH
Legal business name
VIBRA HOSPITAL OF MAHONING VALLEY LLC
Doing business as
Vibra Hospital of Mahoning Valley
Practice address
8049 South Ave
Boardman, OH 44512-6154
Phone
(330) 726-5021
Fax
(330) 726-5053
NPI assigned
Dec 12, 2008
Last updated
Dec 14, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2018

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

Authorized official

Name
Mr. Clint T. Fegan
Title
Sec/Treas
Phone
(717) 591-5700

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X 1428 OH
Long Term Care Hospital 282E00000X 1428 OH Primary

Addresses

Primary practice location

8049 South Ave
Boardman, OH 44512-6154

Mailing address

5 East River Park Place E #460
Fresno, CA 93720-1560
Phone (559) 892-2500

Other identifiers 2

IdentifierTypeStateIssuer
1032312470001MedicaidPA
3140729MedicaidOH

Other names 1

  • Vibra Hospital of Mahoning Valley Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1229040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1544745600000",
    "number": "1528203049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 EAST RIVER PARK PLACE E #460",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937201560",
            "telephone_number": "559-892-2500",
            "fax_number": "559-892-2442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8049 SOUTH AVE",
            "city": "BOARDMAN",
            "state": "OH",
            "postal_code": "445126154",
            "telephone_number": "330-726-5021",
            "fax_number": "330-726-5053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIBRA HOSPITAL OF MAHONING VALLEY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-12",
        "last_updated": "2018-12-14",
        "status": "A",
        "authorized_official_last_name": "FEGAN",
        "authorized_official_first_name": "CLINT",
        "authorized_official_middle_name": "T.",
        "authorized_official_title_or_position": "SEC/TREAS",
        "authorized_official_telephone_number": "717-591-5700",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "OH",
            "license": "1428",
            "primary": false
        },
        {
            "code": "282E00000X",
            "taxonomy_group": "",
            "desc": "Long Term Care Hospital",
            "state": "OH",
            "license": "1428",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1032312470001",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3140729",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vibra Hospital of Mahoning Valley",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Vibra Hospital of Mahoning Valley",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Boardman, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2018; 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.