Penn Highlands Life's Journey

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

Legal business name

PENN HIGHLANDS LIFE'S JOURNEY

Practice address

190 W Park Ave
Du Bois, PA 15801-2277

Phone

(814) 371-1900

Fax

(814) 503-8568

NPI assigned

Apr 6, 2018

Organization subpart

Yes

Parent organization

PENN HIGHLANDS HEALTHCAREAs reported in NPPES

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

Authorized official

Name

Russell Cameron, MDNPI 1073523353

Title

Director, Authorized Official

Phone

(814) 375-3442

Specialties & licenses 2

Addresses

Part of

Penn Highlands Healthcare

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Penn Highlands Healthcare

  • Emergency Medicine Physician
  • Du Bois, PA
  • NPI 1508453010
  NPPES parent name

Practitioners 2

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

• Russell E. Cameron, M.D.

  • Emergency Medicine Physician
  • Du Bois, PA
  • NPI 1073523353
  NPD Authorized official
• Tracey P Grim, MD

  • Obstetrics & Gynecology Physician
  • Milford, DE
  • NPI 1447282116
  NPD (past)

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

{
    "created_epoch": "1522972800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1540857600000",
    "number": "1558868570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 HOSPITAL AVE",
            "city": "DU BOIS",
            "state": "PA",
            "postal_code": "158011440",
            "telephone_number": "814-375-4024",
            "fax_number": "814-372-2579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "190 W PARK AVE",
            "city": "DU BOIS",
            "state": "PA",
            "postal_code": "158012277",
            "telephone_number": "814-371-1900",
            "fax_number": "814-503-8568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENN HIGHLANDS LIFE'S JOURNEY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PENN HIGHLANDS HEALTHCARE",
        "enumeration_date": "2018-04-06",
        "last_updated": "2018-10-30",
        "status": "A",
        "authorized_official_last_name": "CAMERON",
        "authorized_official_first_name": "RUSSELL",
        "authorized_official_title_or_position": "DIRECTOR, AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "814-375-3442",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207VM0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David B Peisner, MD
• Alyssa Marie Pendolino, LSW
• Penn Family Dental Inc
• Penn Highlands Healthcare
• Penn Highlands Home Medical Equipment LLC
• Penn Highlands Radiology Inc
• Penn Traffic Co (Bilo Foods and Pharmacy 9003)
• Pennsylvania CVS Pharmacy LLC (CVS Pharmacy #05709)
• Jacob Penvose, LPC
• Peritech Home Health Associates LLC (Angels of Care of PA)

• Obstetrics & Gynecology Physician in Du Bois, PA
• Providers in Du Bois, PA by specialty
• Obstetrics & Gynecology Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 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.