Individual provider Active NPI

Dallas Joseph Cousins, RN,NP

  • Family Nurse Practitioner
  • Kittanning, PA
National Provider Identifier
1669140240
Registry record updated Aug 31, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN695719 Issued in PA
Practice address
77 Glade Dr
Kittanning, PA 16201-7140
Phone
(724) 545-2205
Fax
(724) 545-2600
NPI assigned
Aug 31, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN695719 PA Primary

Addresses

Primary practice location

77 Glade Dr
Kittanning, PA 16201-7140

Mailing address

PO Box 977
Kittanning, PA 16201-0977
Phone (800) 634-0201

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211227001450 PA Practitioner - Nurse Practitioner 9830580984 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Phoenix Rehabilitation and Health Services IncGroup PAC ID 3476464298, shared by 2 NPIs, 2,775 clinicians
Glade Run Medical Associates IncGroup PAC ID 3577696897, 27 clinicians

Practice addresses (Care Compare)

2000 Westinghouse Dr
Suite 200
Cranberry Township, PA 16066-5238

77 Glade Dr
Kittanning, PA 16201-7140
Phone (724) 545-2205

Hospital & facility affiliations

  • Acmh Hospital Hospital, Kittanning, PA, CCN 390163

Merit-based Incentive Payment System (MIPS)

Final score
93.9 of 100Reported as apm
Quality
85.02
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN695719PAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Glade Run Medical Associates, Inc CurrentSince Dec 10, 2021 Accepting new patients
Glade Run Medical Associates Inc Current Accepting new patients
Glade Run Medical Associates Inc CurrentSince Dec 10, 2021 Accepting new patients

Locations

77 Glade Dr
Kittanning, PA 16201
Phone (724) 545-2205

1 Nolte Dr
Kittanning, PA 16201
Phone (724) 543-8109

700 Medical Arts Bldg
Ste 710
Kittanning, PA 16201
Phone (724) 543-8626

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1630368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630368000000",
    "number": "1669140240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 977",
            "city": "KITTANNING",
            "state": "PA",
            "postal_code": "162010977",
            "telephone_number": "800-634-0201",
            "fax_number": "844-442-5123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 GLADE DR",
            "city": "KITTANNING",
            "state": "PA",
            "postal_code": "162017140",
            "telephone_number": "724-545-2205",
            "fax_number": "724-545-2600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COUSINS",
        "first_name": "DALLAS",
        "middle_name": "JOSEPH",
        "credential": "RN,NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-08-31",
        "last_updated": "2021-08-31",
        "certification_date": "2021-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "RN695719",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kittanning, PA

Sources for this page

Verify at the official NPI Registry.