NPIMap

Organization Active NPI

Upmc Western Maryland Corporation

Doing business as UPMC Western Maryland

  • Clinic/Center
  • Cumberland, MD
National Provider Identifier
1780251850
Registry record updated May 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
UPMC WESTERN MARYLAND CORPORATION
Doing business as
UPMC Western Maryland
Practice address
625 Kent Ave Ste 102
Cumberland, MD 21502-3798
Phone
(240) 964-4288
Fax
(240) 964-4280
NPI assigned
Jun 8, 2021
Last updated
May 31, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 31, 2023

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

Authorized official

Name
Amber Ruble
Title
Sr Vice President/Cfo
Phone
(240) 964-8032

Specialties & licenses 11

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Otolaryngology Physician 207YP0228X
Pediatrics Physician 208000000X
Pediatric Cardiology Physician 2080P0202X
Pediatric Endocrinology Physician 2080P0205X
Pediatric Gastroenterology Physician 2080P0206X
Pediatric Nephrology Physician 2080P0210X
Pediatric Sports Medicine Physician 2080S0010X
Pediatric Rehabilitation Medicine Physician 2081P0010X
Neurology with Special Qualifications in Child Neurology Physician 2084N0402X
Clinic/Center 261Q00000X Primary
Pediatric Orthopaedic Surgery Physician 207XP3100X

Addresses

Primary practice location

625 Kent Ave Ste 102
Cumberland, MD 21502-3798

Mailing address

PO Box 1671
Cumberland, MD 21501-1671
Phone (240) 964-8342

Other names 1

  • UPMC Western Maryland Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040608000157 MD Part B Supplier - Clinic/Group Practice 7113900655 Receives reassigned benefits from 251 practitioners
8 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Lavale, MD; Oakland, MD; MC Henry, MD; Lonaconing, MD; Frostburg, MD; Cumberland, MD
O20070614000318 MD Part A Provider - Hospital 7113900655 3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Cumberland, MD

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1780251850. Details of each certification follow.

Hospital certification: CCN 210027

Legal name
UPMC WESTERN MARYLAND CORPORATION
Doing business as
UPMC WESTERN MARYLAND
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Aug 13, 1993
Beds
240
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
Mar 14, 1905 in MD
Enrollment address
12500 Willowbrook Road
Cumberland, MD 21502-6393
Other Hospital Practice Location
Hospital subgroups
Acute care

Other NPIs on the same Medicare enrollment 7

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Western Maryland Regional Medical CenterCCN 210027 · All quality measures
Overall star rating
4 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 15

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Keith Funkhouser Individual Corporate OfficerTreasurer Jan 23, 2020
Corporate DirectorBoard Member May 24, 2014
John Pappas Individual Corporate DirectorBoard Member Jan 1, 2016
Carissa L Rodeheaver Individual Corporate Director Aug 2, 2021
Richard John Wadas Individual Corporate Director Sep 22, 2022
Courtney Thomas Winterberg Individual Corporate DirectorBoard Member Mar 28, 2013
Kim Leonard Individual Corporate DirectorBoard Member Jul 27, 2018
Amber Ruble Individual Corporate OfficerCfo Jun 26, 2021
W-2 Managing EmployeeCfo Jun 26, 2021
David Landon Burwell Individual Corporate DirectorBoard Member Feb 1, 2020
Jonathan Hutcherson Individual Corporate DirectorBoard Member Jul 1, 2016
Rolf Haarstad Individual Corporate OfficerChair Jul 1, 2016
Corporate DirectorBoard Member Oct 6, 2010
David P Gibbons Individual Corporate Director Mar 21, 2024
Mary Anne Jenkins Individual Corporate OfficerVice Chair Jul 1, 2017
Corporate DirectorBoard Member Dec 12, 2013
Upmc Organization, Pittsburgh, PA Corporation, Non-profit 5% Or Greater Direct Ownership Interest Feb 1, 2020 100%
Michele Martz Individual W-2 Managing EmployeePresident Mar 26, 2021
Eileen Simmons Individual Corporate DirectorBoard Member Feb 1, 2020

Owners & managing parties with NPI records 3

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 15

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 15

Affiliated clinicians 389

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 389

NPI Registry JSON

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

{
    "created_epoch": "1623110400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1685491200000",
    "number": "1780251850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1671",
            "city": "CUMBERLAND",
            "state": "MD",
            "postal_code": "215011671",
            "telephone_number": "240-964-8342",
            "fax_number": "240-964-8337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 KENT AVE STE 102",
            "city": "CUMBERLAND",
            "state": "MD",
            "postal_code": "215023798",
            "telephone_number": "240-964-4288",
            "fax_number": "240-964-4280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UPMC WESTERN MARYLAND CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-08",
        "last_updated": "2023-05-31",
        "certification_date": "2023-05-31",
        "status": "A",
        "authorized_official_last_name": "RUBLE",
        "authorized_official_first_name": "AMBER",
        "authorized_official_title_or_position": "SR VICE PRESIDENT/CFO",
        "authorized_official_telephone_number": "240-964-8032"
    },
    "taxonomies": [
        {
            "code": "207YP0228X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Pediatric Otolaryngology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0205X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0210X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Nephrology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080S0010X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Sports Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2081P0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pediatric Rehabilitation Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207XP3100X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Pediatric Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "UPMC Western Maryland",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "UPMC Western Maryland",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cumberland, MD

Sources for this page

Verify at the official NPI Registry.