NPIMap

Organization Active NPI

Charles Cole Memorial D/B/a Upmc Cole

  • Ambulatory Surgical Clinic/Center
  • Coudersport, PA
National Provider Identifier
1619008554
Registry record updated Nov 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
CHARLES COLE MEMORIAL D/B/A UPMC COLE
Practice address
1001 E 2ND St
Coudersport, PA 16915-8161
Phone
(814) 274-9300
NPI assigned
Mar 9, 2007
Last updated
Nov 6, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2023

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

Authorized official

Name
Roger C. Yost
Title
Cfo
Phone
(570) 321-3175

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X Primary

Addresses

Primary practice location

1001 E 2ND St
Coudersport, PA 16915-8161

Mailing address

1001 E 2ND St
Coudersport, PA 16915-8161
Phone (814) 274-9300

Other identifiers 1

IdentifierTypeStateIssuer
1000011270090MedicaidPA

Other names 1

  • Short Procedure Unit Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070504000079 PA Part A Provider - Critical Access Hospital 3779487475 Receives reassigned benefits from 65 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Coudersport, PA; Shinglehouse, PA; Port Allegany, PA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1619008554. Details of each certification follow.

Hospital certification: CCN 391313

Legal name
CHARLES COLE MEMORIAL HOSPITAL
Doing business as
UPMC COLE
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Aug 1, 2007
Last certification
Mar 3, 2023
Beds
49 (25 certified)
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
Aug 4, 1910 in PA
Enrollment address
1001 E 2ND St
Coudersport, PA 16915-8161
Main/Primary Hospital Location

Facilities connected through Provider of Services related, parent or unit certification numbers.

View all 13

Other NPIs on the same Medicare enrollment 1

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Upmc ColeCCN 391313 · All quality measures
Overall star rating
4 of 5
Type
Critical Access Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Tax ID family
Charles Cole Mem Hosp L51 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

1001 E 2nd St
Fl 4
Coudersport, PA 16915

102 S Main St
Coudersport, PA 16915
Phone (814) 274-0384

269 Route 6 W
Coudersport, PA 16915
Phone (814) 274-0384

45 N Pine St
Port Allegany, PA 16743
Phone (814) 642-2505

15 Meade St
Ste U3
Wellsboro, PA 16901
Phone (570) 724-3636

Ownership & related parties

All disclosed owners & managing parties 15

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Vijayant Singh Individual Corporate DirectorBoard Member Apr 1, 2025
Terrance L Foust Individual Corporate DirectorEx-Officio Chief of Staff Nov 10, 2022
Matthew Splain Individual Corporate OfficerVice Chairman Nov 11, 2025
Corporate DirectorBoard Member Nov 11, 2025
Patricia Jackson Gehris Individual Corporate DirectorBoard Member Jun 15, 2022
Christina Stager Individual Corporate DirectorBoard Member Nov 14, 2024
Erin E Taylor Individual Corporate DirectorBoard Member Nov 11, 2025
Patrick Larsen Individual Corporate OfficerChairperson Nov 11, 2025
Corporate DirectorBoard Member Nov 11, 2025
Josh Costa Individual Corporate OfficerTreasurer Nov 11, 2025
Corporate DirectorBoard Member Nov 11, 2025
Carrie Ennis Individual Corporate DirectorBoard Member Mar 1, 2018
Michelle D Jack Individual Corporate DirectorBoard Member Nov 11, 2025
Ron Reynolds Individual Corporate OfficerHospital President Oct 6, 2025
Corporate DirectorBoard Member Oct 6, 2025
W-2 Managing EmployeeHospital President Oct 6, 2025
Connie J Perkins Individual Corporate DirectorBoard Member Nov 10, 2022
Roger C Yost Individual Corporate OfficerCfo Jan 4, 2024
W-2 Managing EmployeeNcpa Cfo Jan 4, 2024
Upmc Organization, Pittsburgh, PA Corporation, Non-profit 5% Or Greater Direct Ownership Interest Mar 1, 2018 100%
Mary Ann Rigas Individual Corporate OfficerSecretary Nov 11, 2025
Corporate DirectorBoard Member Nov 11, 2025

Owners & managing parties with NPI records 3

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 80

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 80

Affiliated clinicians 182

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 182

NPI Registry JSON

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

{
    "created_epoch": "1173398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1699228800000",
    "number": "1619008554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 E 2ND ST",
            "city": "COUDERSPORT",
            "state": "PA",
            "postal_code": "169158161",
            "telephone_number": "814-274-9300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 E 2ND ST",
            "city": "COUDERSPORT",
            "state": "PA",
            "postal_code": "169158161",
            "telephone_number": "814-274-9300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLES COLE MEMORIAL D/B/A UPMC COLE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-09",
        "last_updated": "2023-11-06",
        "certification_date": "2023-11-06",
        "status": "A",
        "authorized_official_last_name": "YOST",
        "authorized_official_first_name": "ROGER",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "570-321-3175"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1000011270090",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Short Procedure Unit",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Coudersport, PA

Sources for this page

Verify at the official NPI Registry.