NPIMap

Organization Active NPI

Cornell Abraxas Group Inc

  • Psychiatric Residential Treatment Facility
  • Erie, PA
National Provider Identifier
1649322157
Registry record updated Jan 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric Residential Treatment FacilityTaxonomy code 323P00000X
License
405190 Issued in PA
Legal business name
CORNELL ABRAXAS GROUP INC
Practice address
437 W 6TH St
Erie, PA 16507-1215
Phone
(814) 459-0618
Fax
(814) 459-0682
NPI assigned
Jan 17, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2013

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

Authorized official

Name
Dr. Baron Denniston, M.D.
Title
Consulting Psychiatrist
Phone
(814) 459-0618

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Residential Treatment Facility 323P00000X 405190 PA Primary

Addresses

Primary practice location

437 W 6TH St
Erie, PA 16507-1215

Mailing address

437 W 6TH St
Erie, PA 16507-1215
Phone (814) 459-0618

Other identifiers 1

IdentifierTypeStateIssuer
1007472500001MedicaidPA

Other names 1

  • Cornell Abraxas ERMH Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Cornell Abraxas Group LLC11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

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

NPI Registry JSON

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

{
    "created_epoch": "1168992000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1358294400000",
    "number": "1649322157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "437 W 6TH ST",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165071215",
            "telephone_number": "814-459-0618",
            "fax_number": "814-459-0682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "437 W 6TH ST",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165071215",
            "telephone_number": "814-459-0618",
            "fax_number": "814-459-0682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORNELL ABRAXAS GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-17",
        "last_updated": "2013-01-16",
        "status": "A",
        "authorized_official_last_name": "DENNISTON",
        "authorized_official_first_name": "BARON",
        "authorized_official_title_or_position": "CONSULTING PSYCHIATRIST",
        "authorized_official_telephone_number": "814-459-0618",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "323P00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Residential Treatment Facility",
            "state": "PA",
            "license": "405190",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007472500001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cornell Abraxas ERMH",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Erie, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2013; 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.