NPIMap

Organization Active NPI

Regional Health Services, Inc.

Doing business as South Ridge Family Medicine

  • Clinical Medical Laboratory
  • Erie, PA
National Provider Identifier
1801177431
Registry record updated Sep 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
REGIONAL HEALTH SERVICES, INC.
Doing business as
South Ridge Family Medicine
Practice address
4125 W Ridge Rd
Erie, PA 16506-1763
Phone
(814) 838-7778
Fax
(814) 838-9879
NPI assigned
Sep 9, 2011
Last updated
Sep 9, 2011By the provider in NPPES
Organization subpart
Yes
Parent organization
REGIONAL HEALTH SERVICES, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 9, 2011

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

Authorized official

Name
Jason N. Roeback
Title
President
Phone
(814) 877-4242

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X NU Primary

Addresses

Primary practice location

4125 W Ridge Rd
Erie, PA 16506-1763

Mailing address

717 State St Ste 16
Erie, PA 16501-1360
Phone (814) 877-7100

Other names 1

  • South Ridge Family Medicine Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Regional Health Service79 organizations share this tax ID, including this one
Part of
Regional Health Service

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

NPI Registry JSON

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

{
    "created_epoch": "1315526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1315526400000",
    "number": "1801177431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "717 STATE ST STE 16",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165011360",
            "telephone_number": "814-877-7100",
            "fax_number": "814-877-2939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4125 W RIDGE RD",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165061763",
            "telephone_number": "814-838-7778",
            "fax_number": "814-838-9879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REGIONAL HEALTH SERVICES, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "REGIONAL HEALTH SERVICES, INC.",
        "enumeration_date": "2011-09-09",
        "last_updated": "2011-09-09",
        "status": "A",
        "authorized_official_last_name": "ROEBACK",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "N.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "814-877-4242"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "South Ridge Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Erie, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2011; 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.