Active NPI
Geisinger Clinic
- Family Medicine Physician
- Philipsburg, PA
National Provider Identifier
1720039233
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- Legal business name
- GEISINGER CLINIC
- Practice address
- 210 Medical Center Dr
Philipsburg, PA 16866-1948 - Phone
- (814) 342-8001
- NPI assigned
- May 12, 2006
- Last updated
- Jun 27, 2008
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Kenneth Holdren
- Title
- Cao
- Phone
- (570) 271-5490
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | NU | ||
| Nurse Practitioner | 363L00000X | NU | ||
| Family Medicine Physician | 207Q00000X | NU | Primary | |
| Internal Medicine Physician | 207R00000X | NU | ||
| Pediatrics Physician | 208000000X | NU |
Addresses
Primary practice location
210 Medical Center Dr
Philipsburg, PA 16866-1948
Mailing address
100 N Academy Ave
Danville, PA 17822-3034
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040130000518 | PA | Part B Supplier - Clinic/Group Practice | 5395657001 |
Receives reassigned benefits from 5,323 practitioners This NPI is an additional NPI on the enrollment |
National Provider Directory
National Provider Directory- Tax ID family
- Geisinger Health System
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.
-
- Surgery Physician
- Danville, PA
- NPI 1689191355
-
- Family Medicine Physician
- West Hazleton, PA
- NPI 1689001778
-
- Orthopaedic Surgery Physician
- Lewisburg, PA
- NPI 1689214488
-
- Family Medicine Physician
- Frackville, PA
- NPI 1689626152
-
- Registered Dietetic Technician
- Danville, PA
- NPI 1689885618
-
- Physical Therapist
- Scranton, PA
- NPI 1699280107
-
- Nurse Practitioner
- Danville, PA
- NPI 1699703140
-
- Family Medicine Physician
- Carbondale, PA
- NPI 1700212917
-
- Addiction Medicine (Psychiatry & Neurology) Physician
- Waverly, PA
- NPI 1700683661
-
- Family Medicine Physician
- Bellefonte, PA
- NPI 1700836228
-
- Surgery Physician
- Lock Haven, PA
- NPI 1700838000
-
dba PrimeMed Medical Grp Honesdale in collaboration w/ Geisinger Clinic
- Family Medicine Physician
- Honesdale, PA
- NPI 1720495393
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147392000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1214524800000",
"number": "1720039233",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 N ACADEMY AVE",
"city": "DANVILLE",
"state": "PA",
"postal_code": "178223034"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "210 MEDICAL CENTER DR",
"city": "PHILIPSBURG",
"state": "PA",
"postal_code": "168661948",
"telephone_number": "814-342-8001"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "GEISINGER CLINIC",
"organizational_subpart": "NO",
"enumeration_date": "2006-05-12",
"last_updated": "2008-06-27",
"status": "A",
"authorized_official_last_name": "HOLDREN",
"authorized_official_first_name": "KENNETH",
"authorized_official_title_or_position": "CAO",
"authorized_official_telephone_number": "570-271-5490"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NU",
"license": null,
"primary": true
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NU",
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Philipsburg, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.