NPIMap

Organization Active NPI

Canonsburg General Hospital - Spu

  • Ambulatory Surgical Clinic/Center
  • Canonsburg, PA
National Provider Identifier
1710007596
Registry record updated Aug 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
29530100 Issued in PA
Legal business name
CANONSBURG GENERAL HOSPITAL - SPU
Practice address
100 Medical Blvd
Canonsburg, PA 15317-9762
Phone
(724) 745-6100
Fax
(724) 873-1116
NPI assigned
Mar 29, 2007
Last updated
Aug 9, 2007By the provider in NPPES
Organization subpart
Yes
Parent organization
CANONSBURG GENERAL HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 9, 2007

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

Authorized official

Name
Kimberly Malinky
Title
Ceo
Phone
(724) 873-5892

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X 29530100 PA Primary

Addresses

Primary practice location

100 Medical Blvd
Canonsburg, PA 15317-9762

Mailing address

100 Medical Blvd
Canonsburg, PA 15317-9762
Phone (724) 745-6100

Other identifiers 1

IdentifierTypeStateIssuer
100727730003MedicaidPA

National Provider Directory

National Provider Directory
Tax ID family
Forbes Family Practice4 organizations share this tax ID, including this one
Part of
Forbes Family Practice

Other organizations with this tax ID 3

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

Practitioners & affiliated clinicians

Practitioners 7

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": "1175126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1186617600000",
    "number": "1710007596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MEDICAL BLVD",
            "city": "CANONSBURG",
            "state": "PA",
            "postal_code": "153179762",
            "telephone_number": "724-745-6100",
            "fax_number": "724-873-1116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MEDICAL BLVD",
            "city": "CANONSBURG",
            "state": "PA",
            "postal_code": "153179762",
            "telephone_number": "724-745-6100",
            "fax_number": "724-873-1116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CANONSBURG GENERAL HOSPITAL - SPU",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CANONSBURG GENERAL HOSPITAL",
        "enumeration_date": "2007-03-29",
        "last_updated": "2007-08-09",
        "status": "A",
        "authorized_official_last_name": "MALINKY",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "724-873-5892"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "PA",
            "license": "29530100",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100727730003",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Canonsburg, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 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.