NPIMap

Organization Active NPI

Dubois Regional Medical Center

  • Family Medicine Physician
  • Clearfield, PA
National Provider Identifier
1639830664
Registry record updated Jan 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
DUBOIS REGIONAL MEDICAL CENTER
Practice address
807 Turnpike Ave Ste 120
Clearfield, PA 16830-1238
Phone
(814) 765-2261
Fax
(814) 765-4421
NPI assigned
Jan 3, 2022
Organization subpart
Yes
Parent organization
PENN HIGHLANDS HEALTHCAREAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 3, 2022

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

Authorized official

Name
Brian S Kline
Title
Cfo, Authorized Official
Phone
(814) 375-6377

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X

Addresses

Primary practice location

807 Turnpike Ave Ste 120
Clearfield, PA 16830-1238

Mailing address

100 Hospital Ave
Du Bois, PA 15801-1440
Phone (814) 375-4200

Other identifiers 3

IdentifierTypeStateIssuer
106218OtherPAPTAN
100774088-0220MedicaidPA
100774088-0070MedicaidPA

Other names 2

  • Penn Highlands DuBois Doing business as
  • Penn Highlands Family Medicine Clearfield Other name

National Provider Directory

National Provider Directory
Tax ID family
Patrick Shilala123 organizations share this tax ID, including this one
Part of
Penn Highlands Healthcare

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

Ownership & related parties

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.

NPI Registry JSON

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

{
    "created_epoch": "1641168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1641168000000",
    "number": "1639830664",
    "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": "814-375-4200",
            "fax_number": "814-375-4232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "807 TURNPIKE AVE STE 120",
            "city": "CLEARFIELD",
            "state": "PA",
            "postal_code": "168301238",
            "telephone_number": "814-765-2261",
            "fax_number": "814-765-4421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DUBOIS REGIONAL MEDICAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PENN HIGHLANDS HEALTHCARE",
        "enumeration_date": "2022-01-03",
        "last_updated": "2022-01-03",
        "certification_date": "2021-12-30",
        "status": "A",
        "authorized_official_last_name": "KLINE",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "CFO, AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "814-375-6377"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "106218",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100774088-0220",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100774088-0070",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Penn Highlands DuBois",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Penn Highlands Family Medicine Clearfield",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Clearfield, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2022; 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.