NPIMap

Organization Active NPI

Nulton Diagnostic & Treatment Center, PC.

  • Community/Behavioral Health Agency
  • Johnstown, PA
National Provider Identifier
1649515552
Registry record updated Apr 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
330020 Issued in PA
Legal business name
NULTON DIAGNOSTIC & TREATMENT CENTER, PC.
Practice address
110 Franklin Street
Suite 100
Johnstown, PA 15901
Phone
(814) 410-2106
Fax
(814) 410-2108
NPI assigned
Dec 4, 2012
Organization subpart
Yes
Parent organization
NULTON DIAGNOSTIC AND TREATMENT CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 28, 2014

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

Authorized official

Name
Patricia Griesheimer
Title
Director of Billing
Phone
(814) 262-0025

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 330020 PA Primary

Addresses

Primary practice location

110 Franklin Street
Suite 100
Johnstown, PA 15901

Mailing address

214 College Park Plaza
Johnstown, PA 15904
Phone (814) 262-0025

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040225000665 PA Part B Supplier - Clinic/Group Practice 5294621363 Receives reassigned benefits from 54 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Johnstown, PA

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
Nulton Diagnostic Treatment Center PC

Locations

145 Clark Building Rd
Ste 5
Bedford, PA 15522
Phone (814) 623-5009

110 Franklin St
Ste 100
Johnstown, PA 15901
Phone (814) 410-2106

321 Main St
Ste 5H
Johnstown, PA 15901
Phone (814) 262-0025

Practitioners & affiliated clinicians

Practitioners 55

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 55

NPI Registry JSON

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

{
    "created_epoch": "1354579200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1398643200000",
    "number": "1649515552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "214 COLLEGE PARK PLAZA",
            "city": "JOHNSTOWN",
            "state": "PA",
            "postal_code": "15904",
            "telephone_number": "814-262-0025",
            "fax_number": "814-266-8745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 FRANKLIN STREET",
            "address_2": "SUITE 100",
            "city": "JOHNSTOWN",
            "state": "PA",
            "postal_code": "15901",
            "telephone_number": "814-410-2106",
            "fax_number": "814-410-2108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NULTON DIAGNOSTIC & TREATMENT CENTER, PC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NULTON DIAGNOSTIC AND TREATMENT CENTER",
        "enumeration_date": "2012-12-04",
        "last_updated": "2014-04-28",
        "status": "A",
        "authorized_official_last_name": "GRIESHEIMER",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_title_or_position": "DIRECTOR OF BILLING",
        "authorized_official_telephone_number": "814-262-0025"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "PA",
            "license": "330020",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnstown, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.