NPIMap

Organization Active NPI

Cornerstone Coordinated Health Care, LLC

  • Rural Health Clinic/Center
  • Frackville, PA
National Provider Identifier
1811269186
Registry record updated Jul 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
CORNERSTONE COORDINATED HEALTH CARE, LLC
Practice address
40 W Frack St
Frackville, PA 17931-1719
Phone
(610) 393-0787
NPI assigned
Feb 2, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2012

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

Authorized official

Name
Dr. James C Greenfield, DONPI 1396700845
Title
Physician/Owner
Phone
(610) 360-2029

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

40 W Frack St
Frackville, PA 17931-1719

Mailing address

40 W Frack St
Frackville, PA 17931-1719

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20120426000222 PA Part A Provider - Rural Health Clinic 2567624232 Practice locations: Frackville, PA
O20120921000187 PA Part B Supplier - Clinic/Group Practice 2567624232 Receives reassigned benefits from 10 practitioners
1 other NPI on this enrollment
Practice locations: Ashland, PA; Frackville, PA

Rural health clinic certification: CCN 393920

Legal name
CORNERSTONE COORDINATED HEALTH CARE, LLC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Sep 19, 2012
Last certification
Sep 10, 2021
Ownership / control type
1A
Organization structure
LLCProprietary
Incorporated
in PA
Enrollment address
40 W Frack St
Frackville, PA 17931-1719

Other NPIs with the same Medicare PAC ID 1

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

Other NPIs on the same Medicare enrollment 1

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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
39D2044625Cornerstone Coordinated Health Care, LLC40 West Frack Street, Frackville, PA 17931Certificate of waiverJul 26, 2028

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 2

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

NameRoleSinceShare
James C Greenfield Individual 5% Or Greater Direct Ownership Interest Apr 9, 2012 100%
W-2 Managing EmployeeBilling/Office Manager Apr 9, 2012
Kerry Hogan Individual W-2 Managing EmployeeBilling Manager Jan 1, 2012 30%

Owners & managing parties with NPI records 1

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

Practitioners & affiliated clinicians

Practitioners 11

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

NPI Registry JSON

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

{
    "created_epoch": "1328140800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1342137600000",
    "number": "1811269186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 W FRACK ST",
            "city": "FRACKVILLE",
            "state": "PA",
            "postal_code": "179311719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 W FRACK ST",
            "city": "FRACKVILLE",
            "state": "PA",
            "postal_code": "179311719",
            "telephone_number": "610-393-0787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORNERSTONE COORDINATED HEALTH CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-02",
        "last_updated": "2012-07-13",
        "status": "A",
        "authorized_official_last_name": "GREENFIELD",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PHYSICIAN/OWNER",
        "authorized_official_telephone_number": "610-360-2029",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Frackville, PA

Sources for this page

Verify at the official NPI Registry.