NPIMap

Organization Active NPI

Susquehanna Physician Services

  • Audiologist
  • Williamsport, PA
National Provider Identifier
1689680233
Registry record updated Oct 18, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
Legal business name
SUSQUEHANNA PHYSICIAN SERVICES
Practice address
1705 Warren Ave
Suite 204
Williamsport, PA 17701-2647
Phone
(570) 326-8360
Fax
(570) 326-8624
NPI assigned
Aug 1, 2006
Last updated
Oct 18, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2007

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

Authorized official

Name
Mr. Charles Santangelo
Title
Executive VP Cfo
Phone
(570) 321-3171

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X Primary
Audiologist-Hearing Aid Fitter 237600000X

Addresses

Primary practice location

1705 Warren Ave
Suite 204
Williamsport, PA 17701-2647

Mailing address

1205 Grampian Blvd
PO Box 3127
Williamsport, PA 17701-1978

Other identifiers 1

IdentifierTypeStateIssuer
716011OtherPAHIGHMARK BLUE SHIELD

Other names 1

  • SPS-Audiology Other name

National Provider Directory

National Provider Directory
Tax ID family
GHS26 organizations share this tax ID, including this one

Other organizations with this tax ID 25

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

View all 25

Practitioners & affiliated clinicians

Practitioners 2

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": "1154390400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192665600000",
    "number": "1689680233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1205 GRAMPIAN BLVD",
            "address_2": "PO BOX 3127",
            "city": "WILLIAMSPORT",
            "state": "PA",
            "postal_code": "177011978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1705 WARREN AVE",
            "address_2": "SUITE 204",
            "city": "WILLIAMSPORT",
            "state": "PA",
            "postal_code": "177012647",
            "telephone_number": "570-326-8360",
            "fax_number": "570-326-8624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUSQUEHANNA PHYSICIAN SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-01",
        "last_updated": "2007-10-18",
        "status": "A",
        "authorized_official_last_name": "SANTANGELO",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "EXECUTIVE VP CFO",
        "authorized_official_telephone_number": "570-321-3171",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "716011",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SPS-Audiology",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Williamsport, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2007; 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.