Organization Active NPI

Highlands Medical Corp

  • Family Medicine Physician
  • Connellsville, PA
National Provider Identifier
1639115637
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
HIGHLANDS MEDICAL CORP
Practice address
2620 Memorial Blvd
Connellsville, PA 15425-1488
Phone
(724) 626-0700
Fax
(724) 626-8700
NPI assigned
Jun 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
William Kozak Jr., M.D.
Title
Owner/Physician
Phone
(724) 626-0700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

2620 Memorial Blvd
Connellsville, PA 15425-1488

Mailing address

506 Athena Dr
Delmont, PA 15626-1005
Phone (724) 468-6869

Other identifiers 1

IdentifierTypeStateIssuer
1014902030001MedicaidPA

National Provider Directory

National Provider Directory

Locations

2620 Memorial Blvd
Ste C
Connellsville, PA 15425
Phone (724) 626-0700

2620 Memorial Blvd
Connellsville, PA 15425
Phone (724) 626-0700

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/15116/brand/1/csg/1/fhir/r4

NPI Registry JSON

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

{
    "created_epoch": "1150761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1639115637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "506 ATHENA DR",
            "city": "DELMONT",
            "state": "PA",
            "postal_code": "156261005",
            "telephone_number": "724-468-6869",
            "fax_number": "724-468-6207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2620 MEMORIAL BLVD",
            "city": "CONNELLSVILLE",
            "state": "PA",
            "postal_code": "154251488",
            "telephone_number": "724-626-0700",
            "fax_number": "724-626-8700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HIGHLANDS MEDICAL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KOZAK",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "724-626-0700",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1014902030001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Connellsville, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.