NPIMap

Organization Active NPI

Dubois Regional Medical Center

  • Pediatrics Physician
  • Du Bois, PA
National Provider Identifier
1801094222
Registry record updated May 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
DUBOIS REGIONAL MEDICAL CENTER
Practice address
100 Hospital Ave
Neonatal Intensive Care Unit
Du Bois, PA 15801-1440
Phone
(814) 375-6428
Fax
(814) 375-6759
NPI assigned
Jul 6, 2007
Last updated
May 25, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
PENN HIGHLANDS HEALTHCAREAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 25, 2022

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
Phone
(814) 375-6377

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU
Nurse Practitioner 363L00000X NU
Family Medicine Physician 207Q00000X NU
Pediatrics Physician 208000000X NU Primary
Neonatal-Perinatal Medicine Physician 2080N0001X NU

Addresses

Primary practice location

100 Hospital Ave
Neonatal Intensive Care Unit
Du Bois, PA 15801-1440

Mailing address

100 Hospital Ave
Du Bois, PA 15801-1440
Phone (814) 375-6428

Other practice location 1

123 Hospital Ave
DuBois, PA 15801
Phone (814) 371-1510

Other practice location 2

21911 Route 119
Punxsutawney, PA 15767-7922
Phone (814) 371-1510

Other identifiers 1

IdentifierTypeStateIssuer
001873102OtherPAHIGHMARK

Other names 1

  • Penn Highlands DuBois Pediatrics & Neonatology Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20071228000099 PA Part A Provider - Hospital 5890689715 27 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
O20131214000130 PA Part B Supplier - Clinic/Group Practice 5890689715 Receives reassigned benefits from 18 practitioners
Practice locations: Dubois, PA; Clearfield, PA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1801094222. Details of each certification follow.

Hospital certification: CCN 390086

Legal name
DUBOIS REGIONAL MEDICAL CENTER
Doing business as
PENN HIGHLANDS DUBOIS
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Mar 27, 2024
Beds
244 (202 certified)
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
Aug 25, 1955 in PA
Enrollment address
100 Hospital Ave
Dubois, PA 15801-1440
Other Hospital Practice Location
Hospital subgroups
General, Acute care, Psychiatric unit

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs on the same Medicare enrollment 27

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

View all 27

Care Compare: Hospital

Medicare Care Compare
Listed as
Penn Highlands DuboisCCN 390086 · All quality measures
Overall star rating
2 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
Part of
Penn Highlands Healthcare

Ownership & related parties

All disclosed owners & managing parties 22

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

NameRoleSinceShare
Douglas Winner Individual Corporate DirectorSystem Chief Financial Officer Aug 12, 2024
Jourdan D Strishock Individual W-2 Managing EmployeeCompliance Supervisor Aug 1, 2021
Russell E Cameron Individual Corporate DirectorChief Medical Information Officer Jul 1, 2016
Penn Highlands Healthcare, Inc. Organization, Du Bois, PA Non-profit 5% Or Greater Direct Ownership Interest Jun 16, 2011 100%
Operational/Managerial Control Jun 16, 2011 100%
Robert W O'Leary Individual Corporate Officer Jul 1, 2021
Trina L Johnson Individual Corporate DirectorChief Medical Officer Oct 21, 2022
Edward Yahner Individual Corporate Officer Jul 1, 2025
Joanne Ryan Individual Corporate Officer Jul 1, 2022
David Lezzer Individual Corporate Officer Jul 1, 2021
James E Devlin Individual Corporate Officer Jul 1, 2022
Carlyn Belczyk Individual Corporate Officer Oct 1, 2021
Samuel Lewis Individual Corporate Officer Feb 1, 2021
Richard L Pfingstler Individual Corporate Officer Jul 1, 2021
Donald E Conrad Individual Corporate Officer Jul 1, 2021
Scott H Foradora Individual Corporate Officer Jul 1, 2020
Mark Norman Individual Corporate DirectorChief Operating Officer Jul 1, 2016
W-2 Managing EmployeeAd; Jul 1, 2016
William H Young Individual Corporate Officer Jul 1, 2021
Mark McGinley Individual Corporate Officer Oct 1, 2021
James B Ryan Individual Corporate Officer Jul 1, 2020
John S Sutika Individual Corporate Officer Jul 1, 2025
Brian S Kline Individual Corporate DirectorChief Financial Officer Jul 1, 2024
W-2 Managing EmployeeAd; Jul 1, 2024
Steven M Fontaine Individual Corporate DirectorChief Executive Officer Jul 1, 2016

Owners & managing parties with NPI records 2

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

All facility ownership & control disclosures 4

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Penn Highlands BrookvilleBrookville, PA, CCN 391312 Hospital Operational/Managerial Control Sep 26, 2007
Dr Arthur Clifton McKinley Health CenterBrookville, PA, CCN 395550 Skilled nursing facility 5% Or Greater Indirect Ownership Interest
Operational/Managerial Control
Adp of the SNF		 Dec 31, 2021
Jan 1, 2024
Sep 25, 2025
Penn Highlands Jefferson ManorBrookville, PA, CCN 395626 Skilled nursing facility 5% Or Greater Indirect Ownership Interest
Adp of the SNF		 Apr 1, 2019
Dec 9, 2025
Penn Highlands BrookvillePhilipsburg, PA, CCN 393430 Rural health clinic Operational/Managerial Control (100%) Oct 1, 2011

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.

Practitioners & affiliated clinicians

Practitioners 23

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 23

Affiliated clinicians 708

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

View all 708

NPI Registry JSON

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

{
    "created_epoch": "1183680000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1653436800000",
    "number": "1801094222",
    "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": "814-375-6428",
            "fax_number": "814-375-6759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 HOSPITAL AVE",
            "address_2": "NEONATAL INTENSIVE CARE UNIT",
            "city": "DU BOIS",
            "state": "PA",
            "postal_code": "158011440",
            "telephone_number": "814-375-6428",
            "fax_number": "814-375-6759"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "123 Hospital Ave",
            "address_purpose": "LOCATION",
            "city": "DuBois",
            "state": "PA",
            "postal_code": "15801",
            "country_code": "US",
            "telephone_number": "814-371-1510",
            "fax_number": "814-371-2922",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "21911 Route 119",
            "address_purpose": "LOCATION",
            "city": "Punxsutawney",
            "state": "PA",
            "postal_code": "157677922",
            "country_code": "US",
            "telephone_number": "814-371-1510",
            "fax_number": "814-371-2922",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "DUBOIS REGIONAL MEDICAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PENN HIGHLANDS HEALTHCARE",
        "enumeration_date": "2007-07-06",
        "last_updated": "2022-05-25",
        "certification_date": "2022-05-09",
        "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_telephone_number": "814-375-6377"
    },
    "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": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK",
            "identifier": "001873102",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Penn Highlands DuBois Pediatrics & Neonatology",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Penn Highlands DuBois Pediatrics & Neonatology",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Du Bois, PA

Sources for this page

Verify at the official NPI Registry.