NPIMap

Organization Active NPI

Mount Nittany Medical Center

  • Clinical Medical Laboratory
  • State College, PA
National Provider Identifier
1831028042
Registry record updated May 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
MOUNT NITTANY MEDICAL CENTER
Practice address
1700 Old Gatesburg Rd
State College, PA 16803-2276
Phone
(814) 231-6876
Fax
(814) 231-7098
NPI assigned
May 14, 2026
Organization subpart
Yes
Parent organization
MOUNT NITTANY MEDICAL CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 14, 2026

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

Authorized official

Name
Bryan Roach
Title
Cfo
Phone
(814) 234-6148

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X Primary

Addresses

Primary practice location

1700 Old Gatesburg Rd
State College, PA 16803-2276

Mailing address

155 Wellness Way
State College, PA 16803-6797
Phone (814) 231-7100

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
39D2042350Mount Nittany Med Ctr Pain MGMT Clinic1700 Old Gatesburg Road, Suite 100, State College, PA 16803Certificate of waiverJun 10, 2028
39D2159483Mount Nittany Medical Center Blue Course1700 Old Galesburg Road, Suite 100, State College, PA 16803Certificate of waiverDec 18, 2026

National Provider Directory

National Provider Directory
Tax ID family
Card Centre Comm Hosp21 organizations share this tax ID, including this one
Part of
Card Centre Comm Hosp

Other organizations with this tax ID 20

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

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1778716800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1778716800000",
    "number": "1831028042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 WELLNESS WAY",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168036797",
            "telephone_number": "814-231-7100",
            "fax_number": "814-238-0790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 OLD GATESBURG RD",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168032276",
            "telephone_number": "814-231-6876",
            "fax_number": "814-231-7098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNT NITTANY MEDICAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MOUNT NITTANY MEDICAL CENTER",
        "enumeration_date": "2026-05-14",
        "last_updated": "2026-05-14",
        "certification_date": "2026-05-14",
        "status": "A",
        "authorized_official_last_name": "ROACH",
        "authorized_official_first_name": "BRYAN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "814-234-6148"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in State College, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.