Staci Kephart, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

MA055616 Issued in PA

Practice address

850 Main Street
Coalport, PA 16627

Phone

(814) 672-5141

Fax

(814) 672-5461

NPI assigned

Aug 20, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/CHDFBD

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.

• Glendale Area Medical Association, Inc

  • Federally Qualified Health Center (FQHC)
  • Coalport, PA
  • NPI 1255300596
  Medicare reassignment
• Clearfield Hospital

  • General Acute Care Hospital
  • Clearfield, PA
  • NPI 1245402411
  NPD (past)
• Windber Hospital, Inc.

  • General Acute Care Hospital
  • Windber, PA
  • NPI 1275620536
  NPD (past)

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

{
    "created_epoch": "1345420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762128000000",
    "number": "1619225828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 MAIN STREET",
            "address_2": "PO BOX 375",
            "city": "COALPORT",
            "state": "PA",
            "postal_code": "16627",
            "telephone_number": "814-672-5141",
            "fax_number": "814-672-5461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 MAIN STREET",
            "city": "COALPORT",
            "state": "PA",
            "postal_code": "16627",
            "telephone_number": "814-672-5141",
            "fax_number": "814-672-5461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEPHART",
        "first_name": "STACI",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-20",
        "last_updated": "2025-11-03",
        "certification_date": "2025-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA055616",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shena A Duprez, LPC
• Mary Elizabeth Gabriel, D.P.T.
• Gregory P Gates, DMD
• Glendale Area Medical Association, Inc
• Glendale Rehabilitation Inc.
• Anthony M Kibelbek, D.M.D.
• Kinetics Counseling
• Laura J Rizzo DMD PC
• Joseph Leyo III, RPH
• Leyos Inc

• Physician Assistant in Coalport, PA
• Providers in Coalport, PA by specialty
• Physician Assistant in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.