NPIMap

Organization Active NPI

Dubois Regional Medical Center

  • Internal Medicine Physician
  • Du Bois, PA
National Provider Identifier
1679673099
Registry record updated Feb 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
DUBOIS REGIONAL MEDICAL CENTER
Practice address
100 Hospital Ave
Du Bois, PA 15801-1440
Phone
(814) 375-3273
Fax
(814) 375-3395
NPI assigned
Sep 25, 2006
Last updated
Feb 17, 2014By the provider in NPPES
Organization subpart
Yes
Parent organization
PENN HIGHLANDS HEALTHCAREAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 17, 2014

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

Authorized official

Name
Mr. Brian S Kline
Title
VP & Cfo
Phone
(814) 375-6377

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X NU Primary

Addresses

Primary practice location

100 Hospital Ave
Du Bois, PA 15801-1440

Mailing address

100 Hospital Ave
Du Bois, PA 15801-1440
Phone (814) 375-3273

Other identifiers 2

IdentifierTypeStateIssuer
1007740880070MedicaidPA
001627556OtherPABLUE CROSS/BLUE SHIELD

Other names 1

  • Penn Highlands DuBois EKG Cardiology FPA Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050318000691 PA Part B Supplier - Clinic/Group Practice 5890689715 Receives reassigned benefits from 10 practitioners
3 other NPIs on this enrollment
Practice locations: Dubois, PA; Saint Marys, PA

Other NPIs on the same Medicare enrollment 3

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

National Provider Directory

National Provider Directory
Tax ID family
Dubois Regional Medical Center - Penn Highlands Dubois Medical Arts123 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

All facility ownership & control disclosures 4

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Penn Highlands BrookvilleBrookville, PA, CCN 391312 Hospital Operational/Managerial Control Sep 26, 2007
Dr Arthur Clifton McKinley Health CenterBrookville, PA, CCN 395550 Skilled nursing facility 5% Or Greater Indirect Ownership Interest
Operational/Managerial Control
Adp of the SNF		 Dec 31, 2021
Jan 1, 2024
Sep 25, 2025
Penn Highlands Jefferson ManorBrookville, PA, CCN 395626 Skilled nursing facility 5% Or Greater Indirect Ownership Interest
Adp of the SNF		 Apr 1, 2019
Dec 9, 2025
Penn Highlands BrookvillePhilipsburg, PA, CCN 393430 Rural health clinic Operational/Managerial Control (100%) Oct 1, 2011

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 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1392595200000",
    "number": "1679673099",
    "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": "814-375-3273",
            "fax_number": "814-375-3395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 HOSPITAL AVE",
            "city": "DU BOIS",
            "state": "PA",
            "postal_code": "158011440",
            "telephone_number": "814-375-3273",
            "fax_number": "814-375-3395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DUBOIS REGIONAL MEDICAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PENN HIGHLANDS HEALTHCARE",
        "enumeration_date": "2006-09-25",
        "last_updated": "2014-02-17",
        "status": "A",
        "authorized_official_last_name": "KLINE",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "VP & CFO",
        "authorized_official_telephone_number": "814-375-6377",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007740880070",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "001627556",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Penn Highlands DuBois EKG Cardiology FPA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Du Bois, PA

Sources for this page

Verify at the official NPI Registry.