NPIMap

Organization Active NPI

Keystone Rural Health Center

Doing business as Keystone Medical Associates Waynesboro

  • Federally Qualified Health Center (FQHC)
  • Waynesboro, PA
National Provider Identifier
1801604236
Registry record updated Dec 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
KEYSTONE RURAL HEALTH CENTER
Doing business as
Keystone Medical Associates Waynesboro
Practice address
12104 Buchanan TRL E
Waynesboro, PA 17268-9429
Phone
(717) 749-0150
Fax
(717) 749-0153
NPI assigned
Dec 18, 2024
Last updated
Dec 18, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
KEYSTONE RURAL HEALTH CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 18, 2024

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

Authorized official

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

Specialties & licenses 1

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

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 1

  • Keystone Medical Associates Waynesboro Doing business as

Medicare participation

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

Enrollment records 2

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

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1801604236. Details of each certification follow.

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
CorporationNon-profit
Enrollment address
12104 Buchanan TRL E
Waynesboro, PA 17268-9429

Other NPIs with the same Medicare PAC ID 22

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

View all 22

Other NPIs on the same Medicare enrollment 19

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

View all 19

National Provider Directory

National Provider Directory
Tax ID family
Keystone Health Center43 organizations share this tax ID, including this one
Part of
Keystone Health Center

Other organizations with this tax ID 42

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

View all 42

Locations

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

Ownership & related parties

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 OtherChair Oct 1, 2017
Michael Kugler Individual Other Jan 1, 2015
Jenna Kaczmarek Individual OtherTreasurer Jan 1, 2024
Timothy Henry Individual Other Dec 1, 2017
Scott Brown Individual Other Jun 2, 2021
Joanne L Cochran Individual Corporate OfficerCeo Sep 24, 1992
W-2 Managing EmployeeCeo Sep 24, 1992
William a Morgan Individual Other Jun 23, 2004
Karen Pickenheim Johnston Individual OtherSecretary 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

Practitioners & affiliated clinicians

Practitioners 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1734480000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734480000000",
    "number": "1801604236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 CHAMBERS HILL DR STE 200",
            "city": "CHAMBERSBURG",
            "state": "PA",
            "postal_code": "172017304",
            "telephone_number": "717-709-7922",
            "fax_number": "717-263-2055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12104 BUCHANAN TRL E",
            "city": "WAYNESBORO",
            "state": "PA",
            "postal_code": "172689429",
            "telephone_number": "717-749-0150",
            "fax_number": "717-749-0153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEYSTONE RURAL HEALTH CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "KEYSTONE RURAL HEALTH CENTER",
        "enumeration_date": "2024-12-18",
        "last_updated": "2024-12-18",
        "certification_date": "2024-12-18",
        "status": "A",
        "authorized_official_last_name": "COCHRAN",
        "authorized_official_first_name": "JOANNE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "717-709-7906"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Keystone Medical Associates Waynesboro",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Waynesboro, PA

Sources for this page

Verify at the official NPI Registry.