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Keystone Rural Health Center

Organization Active NPI Federally Qualified Health Center (FQHC) · Waynesboro, PA

NPI 1801604236 · NPPES record last updated Dec 18, 2024

Key facts

NPI
1801604236
Entity type
Organization (NPI type 2)
Primary specialty
Federally Qualified Health Center (FQHC) 261QF0400X
Legal business name
KEYSTONE RURAL HEALTH CENTER
Practice address
12104 Buchanan TRL E
Waynesboro, PA 17268-9429
Phone
(717) 749-0150
Fax
(717) 749-0153
NPI assigned
Dec 18, 2024
Organization subpart
Yes
Parent organization (as reported)
KEYSTONE RURAL HEALTH CENTER

Authorized official

Name
Joanne Cochran
Title
Ceo
Phone
(717) 709-7906

Other NPIs on the same Medicare enrollment 19

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

Other NPIs with the same Medicare PAC ID 22

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

Corporate family (same tax ID) 41

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

View all 41

Practitioners 46

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 46

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in PA

Federally qualified health center certification: CCN D31034

Legal name
KEYSTONE RURAL HEALTH CENTER
Doing business as
KEYSTONE MEDICAL ASSOCIATES WAYNESBORO
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Apr 16, 2025
Last certification
Apr 16, 2025
Ownership / control type
For profit – corporation
Organization structure
Corporation · Non-profit
Enrollment address
12104 Buchanan TRL E
Waynesboro, PA 17268-9429

All disclosed owners & managing parties 14

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

NameRoleSinceShare
Mark Smith
Individual 		Other May 1, 2024
Muhammad Amer Chaudhry
Individual 		Other Jan 1, 2024
Carrie Gray
Individual 		Other
Chair		 Oct 1, 2017
Michael Kugler
Individual 		Other Jan 1, 2015
Jenna Kaczmarek
Individual 		Other
Treasurer		 Jan 1, 2024
Timothy Henry
Individual 		Other Dec 1, 2017
Scott Brown
Individual 		Other Jun 2, 2021
Joanne L Cochran
Individual 		Corporate Officer
Ceo		 Sep 24, 1992
W-2 Managing Employee
Ceo		 Sep 24, 1992
William a Morgan
Individual 		Other Jun 23, 2004
Karen Pickenheim Johnston
Individual 		Other
Secretary		 Jan 1, 2015
Wanda Dietrich
Individual 		Other Jul 4, 2024
Virginia Harriger
Individual 		Other Nov 3, 2021
Sila Alegret-Bartel
Individual 		Other Jan 1, 2015
Brittany Henderson
Individual 		Other Jan 5, 2022

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20040329000065 PA Part B Supplier - Clinic/Group Practice 5496663312 Receives reassigned benefits from 141 practitioners
24 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Waynesboro, PA; Chambersburg, PA
O20250505002575 PA Part a Provider - Federally Qualified Health Center (FQHC) 5496663312 Practice locations: Waynesboro, PA

National Provider Directory

Tax ID family
Keystone HLTH Ctr (42 organizations share this tax ID)
Part of
Keystone HLTH Ctr

Locations

133 W Catherine St
Ste 100
Chambersburg, PA 17201
Phone (717) 261-4933

12104 Buchanan Trl E
Waynesboro, PA 17268
Phone (717) 749-0150

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Yes

Addresses

Primary practice location

12104 Buchanan TRL E
Waynesboro, PA 17268-9429

Mailing address

111 Chambers Hill Dr Ste 200
Chambersburg, PA 17201-7304
Phone (717) 709-7922

Other names

  • Keystone Medical Associates Waynesboro Doing business as

Other providers in Waynesboro, PA

All providers in Waynesboro, PA · Federally Qualified Health Center (FQHC) in Pennsylvania

Sources for this page

Verify at the official NPI Registry.