Clear Med Provider Group

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

Legal business name

CLEAR MED PROVIDER GROUP

Practice address

2772 Cecil Hurd Hwy
Mahaffey, PA 15757-6322

Phone

(814) 277-4504

Fax

(814) 277-6873

NPI assigned

May 29, 2009

Last updated

Aug 10, 2010By the provider in NPPES

Organization subpart

Yes

Parent organization

CLEARFIELD HOSPITALAs reported in NPPES

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

Authorized official

Name

Rita V Olszewski

Title

Clear Med Administrator

Phone

(814) 768-2356

Specialties & licenses 4

Addresses

Other identifiers 2

Other names 1

• Clear Med Mahaffey Clinic Other name

Tax ID family

Clear Med Provider Corporation6 organizations share this tax ID, including this one

Part of

Clearfield Hospital Ane

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

• Clear Med Provider Corporation

  • Health Service Clinic/Center
  • Clearfield, PA
  • NPI 1013243039
  NPD tax ID
• Clear Med Provider Corporation

  • Health Service Clinic/Center
  • Philipsburg, PA
  • NPI 1083872766
  NPD tax ID
• Clear Med Provider Corporation

  • Health Service Clinic/Center
  • Curwensville, PA
  • NPI 1508024282
  NPD tax ID
• Clear Med Provider Corporation

  • Health Service Clinic/Center
  • Houtzdale, PA
  • NPI 1548428220
  NPD tax ID
• Clear Med Provider Corporation

  • Health Service Clinic/Center
  • Clearfield, PA
  • NPI 1639337322
  NPD tax ID

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

{
    "created_epoch": "1243555200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1281398400000",
    "number": "1629204060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "809 TURNPIKE AVE",
            "city": "CLEARFIELD",
            "state": "PA",
            "postal_code": "168301232",
            "telephone_number": "814-768-2356",
            "fax_number": "814-768-2134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2772 CECIL HURD HWY",
            "city": "MAHAFFEY",
            "state": "PA",
            "postal_code": "157576322",
            "telephone_number": "814-277-4504",
            "fax_number": "814-277-6873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLEAR MED PROVIDER GROUP",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CLEARFIELD HOSPITAL",
        "enumeration_date": "2009-05-29",
        "last_updated": "2010-08-10",
        "status": "A",
        "authorized_official_last_name": "OLSZEWSKI",
        "authorized_official_first_name": "RITA",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "CLEAR MED ADMINISTRATOR",
        "authorized_official_telephone_number": "814-768-2356"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA051554",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD047546L",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD031136L",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001829615",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK",
            "identifier": "0166056",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clear Med Mahaffey Clinic",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Mahaffey Community Ambulance Service

• Health Service Clinic/Center in Mahaffey, PA
• Providers in Mahaffey, PA by specialty
• Health Service Clinic/Center in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2010; 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.