Individual provider Active NPI

Charlene Rae Saloom, D.O.

  • Family Medicine Physician
  • Connellsville, PA
National Provider Identifier
1558387472
Registry record updated Sep 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS013236 Issued in PA
Practice address
208 S. Arch Street
Connellsville, PA 15425-3519
Phone
(724) 626-2630
Fax
(724) 626-2655
NPI assigned
Jul 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OS013236 PA Primary

Addresses

Primary practice location

208 S. Arch Street
Connellsville, PA 15425-3519

Mailing address

1070 Old National Pike Rd
Fredericktown, PA 15333-2114
Phone (724) 632-6801

Other identifiers 2

IdentifierTypeStateIssuer
1007288440037MedicaidPA
101706672MedicaidPA

Other names 1

  • Charlene Saloom Taylor Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061016000004 PA Practitioner - Family Practice 8628072113 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
OS013236PAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
DLP Conemaugh Physician Practices LLC Family Medicine CurrentSince Sep 1, 2019 Accepting new patients
Centerville Clinics, Inc. Current Accepting new patients
DLP Conemaugh Physician Practices LLC Family Medicine Current Accepting new patients
Centerville Clinics Inc Family Medicine CurrentSince May 8, 2024 Accepting new patients
DLP Conemaugh Physician Practices LLC Family Medicine CurrentSince Sep 1, 2019 Accepting new patients
Centerville Clinics, Inc. Current Accepting new patients
Centerville Clinics, Inc. Current Accepting new patients
Centerville Clinics, Inc. Current Accepting new patients
Windber Hospital, Inc. Past Accepting new patients

Locations

1070 Old National Pike
Fredericktown, PA 15333

1111 Franklin St
Ste 180
Johnstown, PA 15905
Phone (814) 534-3740

1086 Franklin St
Johnstown, PA 15905
Phone (610) 250-4540

86 McClellandtown Rd
Uniontown, PA 15401
Phone (724) 430-7990

Interoperability endpoints

  • Direct secure messaging: csaloom@direct.excelahealth.org
  • Direct secure messaging: csaloom38229@direct.conemaugh.org

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317081600000",
    "number": "1558387472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1070 OLD NATIONAL PIKE RD",
            "city": "FREDERICKTOWN",
            "state": "PA",
            "postal_code": "153332114",
            "telephone_number": "724-632-6801",
            "fax_number": "724-632-6312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 S. ARCH STREET",
            "city": "CONNELLSVILLE",
            "state": "PA",
            "postal_code": "154253519",
            "telephone_number": "724-626-2630",
            "fax_number": "724-626-2655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SALOOM",
        "first_name": "CHARLENE",
        "middle_name": "RAE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-14",
        "last_updated": "2011-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS013236",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007288440037",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101706672",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHARLENE",
            "last_name": "TAYLOR",
            "middle_name": "SALOOM",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Connellsville, PA

Sources for this page

Verify at the official NPI Registry.