NPIMap

Organization Active NPI

DLP Conemaugh Memorial Medical Center LLC

Doing business as Conemaugh Diabetes Institute

  • Registered Dietitian
  • Johnstown, PA
National Provider Identifier
1760154975
Registry record updated Oct 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
Legal business name
DLP CONEMAUGH MEMORIAL MEDICAL CENTER LLC
Doing business as
Conemaugh Diabetes Institute
Practice address
1111 Franklin St Ste 180
Johnstown, PA 15905-4341
Phone
(814) 534-6800
NPI assigned
Oct 5, 2021
Last updated
Oct 5, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2021

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

Authorized official

Name
Kathy Teague
Title
Assistant VP & Secretary
Phone
(615) 920-7646

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered DietitianGroup: 193200000X MULTI-SPECIALTY GROUP 133V00000X Primary
Registered NurseGroup: 193200000X MULTI-SPECIALTY GROUP 163W00000X
Health EducatorGroup: 193200000X MULTI-SPECIALTY GROUP 174H00000X

Addresses

Primary practice location

1111 Franklin St Ste 180
Johnstown, PA 15905-4341

Mailing address

330 Seven Springs Way
Brentwood, TN 37027-5098
Phone (615) 920-7000

Other names 1

  • Conemaugh Diabetes Institute Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190822001326 PA MDPP Supplier - in-Person MDPP Supplier 8022238682 1 other NPI on this enrollment
Practice locations: Johnstown, PA

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
DLP Conemaugh Mem Med Ctr9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

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

Locations

210 Ohio St
Boswell, PA 15531
Phone (814) 629-5653

861 Hills Plz
Ste 230
Ebensburg, PA 15931
Phone (814) 472-4468

861 Hills Plz
Ste 240A240B
Ebensburg, PA 15931
Phone (814) 472-4958

1 Tech Park Dr
Ste 1144
Johnstown, PA 15901
Phone (814) 475-8718

1020 Franklin St
Fl 3
Johnstown, PA 15905
Phone (814) 534-1990

1020 Franklin St
Fl 8
Johnstown, PA 15905
Phone (814) 534-1927

1086 Franklin St
Ste D3159
Johnstown, PA 15905
Phone (814) 534-9194

1111 Franklin St
Ste 120A
Johnstown, PA 15905
Phone (814) 534-6800

1111 Franklin St
Ste 160
Johnstown, PA 15905
Phone (814) 534-9183

1111 Franklin St
Ste 180
Johnstown, PA 15905
Phone (814) 534-3740

1111 Franklin St
Ste 220
Johnstown, PA 15905
Phone (814) 472-7933

1111 Franklin St
Ste 40
Johnstown, PA 15905
Phone (814) 534-9183

1450 Scalp Ave
Ste 1
Johnstown, PA 15904
Phone (814) 262-7290

1450 Scalp Ave
Ste 102
Johnstown, PA 15904
Phone (814) 534-1990

1450 Scalp Ave
Ste 103
Johnstown, PA 15904
Phone (814) 534-9665

1450 Scalp Ave
Ste 1050
Johnstown, PA 15904
Phone (814) 266-9686

1450 Scalp Ave
Ste 1052
Johnstown, PA 15904
Phone (814) 266-9686

1940 William Penn Ave
Johnstown, PA 15909
Phone (814) 322-1519

315 Locust St
Ste 5E
Johnstown, PA 15901
Phone (814) 534-6100

315 Locust St
Ste 7
Johnstown, PA 15901
Phone (814) 534-6991

320 Main St
Fl 5
Johnstown, PA 15901
Phone (814) 534-6333

1060 Lloyd St
Rm 1060
Nanty Glo, PA 15943
Phone (814) 749-8624

1291 N Center Ave
Ste 200
Somerset, PA 15501
Phone (814) 417-6400

Practitioners & affiliated clinicians

Practitioners 117

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.

View all 117

NPI Registry JSON

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

{
    "created_epoch": "1633392000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1633392000000",
    "number": "1760154975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 SEVEN SPRINGS WAY",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370275098",
            "telephone_number": "615-920-7000",
            "fax_number": "615-920-8913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 FRANKLIN ST STE 180",
            "city": "JOHNSTOWN",
            "state": "PA",
            "postal_code": "159054341",
            "telephone_number": "814-534-6800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DLP CONEMAUGH MEMORIAL MEDICAL CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-05",
        "last_updated": "2021-10-05",
        "certification_date": "2021-10-05",
        "status": "A",
        "authorized_official_last_name": "TEAGUE",
        "authorized_official_first_name": "KATHY",
        "authorized_official_title_or_position": "ASSISTANT VP & SECRETARY",
        "authorized_official_telephone_number": "615-920-7646"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "174H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Health Educator",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Conemaugh Diabetes Institute",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Johnstown, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2021; 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.

Verify at the official NPI Registry.