NPIMap

Organization Active NPI

Dubois Regional Medical Center

Doing business as Penn Highlands DuBois

  • Ophthalmology Physician
  • Du Bois, PA
National Provider Identifier
1720646649
Registry record updated Jun 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
DUBOIS REGIONAL MEDICAL CENTER
Doing business as
Penn Highlands DuBois
Practice address
529 Sunflower Dr
Du Bois, PA 15801-2378
Phone
(814) 371-2200
NPI assigned
Jun 5, 2019
Last updated
Jun 5, 2019By the provider in NPPES
Organization subpart
Yes
Parent organization
PENN HIGHLANDS HEALTHCAREAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 5, 2019

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

Authorized official

Name
Brian S Kline
Title
VP/Cfo/Authorized Official
Phone
(814) 375-6377

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X NU
Family Medicine Physician 207Q00000X NU
Internal Medicine Physician 207R00000X NU
Ophthalmology Physician 207W00000X NU Primary
Glaucoma Specialist (Ophthalmology) Physician 207WX0009X NU
Retina Specialist (Ophthalmology) Physician 207WX0107X NU

Addresses

Primary practice location

529 Sunflower Dr
Du Bois, PA 15801-2378

Mailing address

100 Hospital Ave
Du Bois, PA 15801-1440
Phone (814) 375-6560

Other identifiers 1

IdentifierTypeStateIssuer
1007740880070MedicaidPA

Other names 2

  • Penn Highlands DuBois Doing business as
  • Penn Highlands DuBois - Sunflower Dr Bldg Other name

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

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.

NPI Registry JSON

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

{
    "created_epoch": "1559692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1559692800000",
    "number": "1720646649",
    "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": "814-375-6560",
            "fax_number": "814-372-2848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "529 SUNFLOWER DR",
            "city": "DU BOIS",
            "state": "PA",
            "postal_code": "158012378",
            "telephone_number": "814-371-2200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DUBOIS REGIONAL MEDICAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PENN HIGHLANDS HEALTHCARE",
        "enumeration_date": "2019-06-05",
        "last_updated": "2019-06-05",
        "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",
        "authorized_official_telephone_number": "814-375-6377"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207WX0009X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Glaucoma Specialist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007740880070",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Penn Highlands DuBois",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Penn Highlands DuBois - Sunflower Dr Bldg",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Du Bois, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2019; 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.