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Organization Active NPI

Dubois Regional Medical Center - Penn Highlands Medical Arts BLDG Elk

  • Family Medicine Physician
  • Saint Marys, PA
National Provider Identifier
1831574375
Registry record updated Feb 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
DUBOIS REGIONAL MEDICAL CENTER - PENN HIGHLANDS MEDICAL ARTS BLDG ELK
Practice address
761 Johnsonburg Rd
Saint Marys, PA 15857-3483
Phone
(814) 371-2200
Fax
(814) 375-4232
NPI assigned
Jul 27, 2015
Organization subpart
Yes
Parent organization
PENN HIGHLANDS HEALTHCAREAs reported in NPPES

Authorized official

NPPES NPI Registry
Name
Brian S Kline
Title
VP/Cfo
Phone
(814) 375-6377

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Corporate family (same tax ID) 24

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

National Provider Directory

National Provider Directory
Tax ID family
Patrick Shilala (123 organizations share this tax ID)

Specialties & licenses 9

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207L00000X
Pain Medicine (Anesthesiology) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207LP2900X
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Orthopaedic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207X00000X
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X
Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208600000X
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X

Addresses

NPPES NPI Registry

Primary practice location

761 Johnsonburg Rd
Saint Marys, PA 15857-3483

Mailing address

100 Hospital Ave
Du Bois, PA 15801-1440
Phone (814) 371-2200

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
1007740880070MedicaidPA

Other names 1

NPPES NPI Registry
  • Penn Highlands DuBois Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Feb 29, 2016.

{
    "created_epoch": "1437955200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1456704000000",
    "number": "1831574375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 HOSPITAL AVE",
            "city": "DU BOIS",
            "state": "PA",
            "postal_code": "158011440",
            "telephone_number": "814-371-2200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "761 JOHNSONBURG RD",
            "city": "SAINT MARYS",
            "state": "PA",
            "postal_code": "158573483",
            "telephone_number": "814-371-2200",
            "fax_number": "814-375-4232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DUBOIS REGIONAL MEDICAL CENTER - PENN HIGHLANDS MEDICAL ARTS BLDG ELK",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PENN HIGHLANDS HEALTHCARE",
        "enumeration_date": "2015-07-27",
        "last_updated": "2016-02-29",
        "status": "A",
        "authorized_official_last_name": "KLINE",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "VP/CFO",
        "authorized_official_telephone_number": "814-375-6377"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007740880070",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Penn Highlands DuBois",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Saint Marys, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 2016; 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.