NPIMap

Organization Active NPI

Broad Top Area Medical Center, Inc

Doing business as BTAMC Belleville Wellness Center

  • Federally Qualified Health Center (FQHC)
  • Belleville, PA
National Provider Identifier
1659945483
Registry record updated Aug 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
BROAD TOP AREA MEDICAL CENTER, INC
Doing business as
BTAMC Belleville Wellness Center
Practice address
375 S Kishacoquillas St
Belleville, PA 17004-8620
Phone
(717) 935-4011
Fax
(717) 935-4012
NPI assigned
May 17, 2021
Last updated
Aug 28, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
BROAD TOP AREA MEDICAL CENTER, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 28, 2026

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

Authorized official

Name
Shani Reed
Title
Director, Enrollment
Phone
(814) 506-8463

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X NU Primary

Addresses

Primary practice location

375 S Kishacoquillas St
Belleville, PA 17004-8620

Mailing address

4133 Medical Center Dr
Broad Top, PA 16621-9001
Phone (814) 635-2916

Other names 1

  • BTAMC Belleville Wellness Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20050420000158 PA Part B Supplier - Clinic/Group Practice 2860430972 Receives reassigned benefits from 35 practitioners
13 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Orbisonia, PA; Mount Union, PA; Broad Top, PA; Huntingdon, PA; Cassville, PA; Belleville, PA; Alexandria, PA
O20210804001900 PA Part A Provider - Federally Qualified Health Center (FQHC) 2860430972 Practice locations: Belleville, PA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1659945483. Details of each certification follow.

Federally qualified health center certification: CCN 731875

Legal name
BROAD TOP AREA MEDICAL CENTER INC
Doing business as
BTAMC BELLEVILLE WELLNESS CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Aug 13, 2021
Last certification
Aug 13, 2021
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
May 5, 1993 in PA
Enrollment address
375 S Kishacoquillas St
Belleville, PA 17004-8620

Other NPIs with the same Medicare PAC ID 11

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 11

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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
39D2222056Btamc Belleville Wellness Center375 S Kishacoquillas Street, Belleville, PA 17004Certificate of waiverApr 26, 2027

National Provider Directory

National Provider Directory
Tax ID family
Brroad Top Area Medical10 organizations share this tax ID, including this one
Part of
Brroad Top Area Medical

Other organizations with this tax ID 9

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

Locations

375 S Kishacoquillas St
Belleville, PA 17004
Phone (717) 935-2065

Ownership & related parties

All disclosed owners & managing parties 17

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Jennifer McMullen Individual Corporate OfficerBoard Member Mar 28, 2019
Tracey Earley Individual W-2 Managing EmployeeHR Director Feb 1, 2018
Franklin Westbrook Individual Corporate OfficerBoard Member Jun 23, 2020
Donna McCabe Individual Corporate OfficerBoard Member Aug 1, 2016
Shani Reed Individual Corporate OfficerDirector/Provider Enrollment Jan 1, 2019
Malvin Deluca Individual Corporate OfficerBoard President Jun 22, 2017
Wendy Melius Individual Corporate OfficerBoard Member/Vice President Jun 1, 2016
John D. Roth Individual Corporate OfficerChief Executive Officer (Ceo) Dec 1, 2018
Matthew Stoudnour Individual Corporate OfficerBoard Member Mar 28, 2019
Paul Wright Individual Corporate OfficerBoard Member Oct 1, 2019
Bertha Peffer Individual Corporate OfficerBoard Member/Tresaurer Jun 22, 2017
Wayne N Fisher Individual Corporate OfficerBoard Member Jun 22, 2017
Kevin Martin Individual Corporate OfficerBoard Member Jun 23, 2020
Jason Horton Individual Corporate OfficerBoard Member Mar 28, 2019
Barbara Lucas Individual Corporate OfficerBoard Member/Secretary Aug 1, 2016
Christopher Crawshaw Individual Corporate OfficerChief Financial Officer (Cfo) Feb 1, 2019
James B Hayden Individual Corporate OfficerChief Medical Officer (Cmo) Dec 1, 2018

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

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.

Practitioners & affiliated clinicians

Practitioners 64

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 64

NPI Registry JSON

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

{
    "created_epoch": "1621209600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1787875200000",
    "number": "1659945483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4133 MEDICAL CENTER DR",
            "city": "BROAD TOP",
            "state": "PA",
            "postal_code": "166219001",
            "telephone_number": "814-635-2916",
            "fax_number": "814-635-2918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "375 S KISHACOQUILLAS ST",
            "city": "BELLEVILLE",
            "state": "PA",
            "postal_code": "170048620",
            "telephone_number": "717-935-4011",
            "fax_number": "717-935-4012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROAD TOP AREA MEDICAL CENTER, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BROAD TOP AREA MEDICAL CENTER, INC",
        "enumeration_date": "2021-05-17",
        "last_updated": "2026-08-28",
        "certification_date": "2026-08-28",
        "status": "A",
        "authorized_official_last_name": "REED",
        "authorized_official_first_name": "SHANI",
        "authorized_official_title_or_position": "DIRECTOR, ENROLLMENT",
        "authorized_official_telephone_number": "814-506-8463"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BTAMC Belleville Wellness Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Belleville, PA

Sources for this page

Verify at the official NPI Registry.