NPIMap

Organization Active NPI

Divine Providence Hospital of the Sisters of Christian Charity

  • General Acute Care Hospital
  • Williamsport, PA
National Provider Identifier
1720162878
Registry record updated Nov 5, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
041001 Issued in PA
Legal business name
DIVINE PROVIDENCE HOSPITAL OF THE SISTERS OF CHRISTIAN CHARITY
Practice address
1100 Grampian Blvd
Williamsport, PA 17701-1909
Phone
(570) 326-8000
Fax
(570) 326-8601
NPI assigned
Oct 25, 2006
Organization subpart
Yes
Parent organization
DIVINE PROVIDENCE HOSPITAL OF THE SISTERS OF CHRISTIAN CHARITYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 5, 2007

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

Authorized official

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X 041001 PA
General Acute Care Hospital 282N00000X 041001 PA Primary
Psychiatric Hospital 283Q00000X 041001 PA

Addresses

Primary practice location

1100 Grampian Blvd
Williamsport, PA 17701-1909

Mailing address

1205 Grampian Blvd
2ND Floor
Williamsport, PA 17701-1978
Phone (570) 326-8676

Other identifiers 1

IdentifierTypeStateIssuer
1007563750020MedicaidPA

Other names 1

  • Divine Providence Hospital Other name

National Provider Directory

National Provider Directory
Tax ID family
Diabetes Center Divine3 organizations share this tax ID, including this one
Part of
Diabetes Center Divine

Other organizations with this tax ID 2

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

NPI Registry JSON

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194220800000",
    "number": "1720162878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1205 GRAMPIAN BLVD",
            "address_2": "2ND FLOOR",
            "city": "WILLIAMSPORT",
            "state": "PA",
            "postal_code": "177011978",
            "telephone_number": "570-326-8676",
            "fax_number": "570-326-8601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 GRAMPIAN BLVD",
            "city": "WILLIAMSPORT",
            "state": "PA",
            "postal_code": "177011909",
            "telephone_number": "570-326-8000",
            "fax_number": "570-326-8601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVINE PROVIDENCE HOSPITAL OF THE SISTERS OF CHRISTIAN CHARITY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DIVINE PROVIDENCE HOSPITAL OF THE SISTERS OF CHRISTIAN CHARITY",
        "enumeration_date": "2006-10-25",
        "last_updated": "2007-11-05",
        "status": "A",
        "authorized_official_last_name": "SANTANGELO",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "EXECUTIVE VP CFO",
        "authorized_official_telephone_number": "570-321-3171",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CPA FHFMA"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "PA",
            "license": "041001",
            "primary": false
        },
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "PA",
            "license": "041001",
            "primary": true
        },
        {
            "code": "283Q00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Hospital",
            "state": "PA",
            "license": "041001",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007563750020",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Divine Providence Hospital",
            "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 Nov 5, 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.