NPIMap

Organization Active NPI

Glade Run Medical Associates

  • Rural Health Clinic/Center
  • Kittanning, PA
National Provider Identifier
1831601962
Registry record updated Aug 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
GLADE RUN MEDICAL ASSOCIATES
Practice address
260 S Jefferson St
Kittanning, PA 16201-2422
Phone
(724) 543-5919
Fax
(724) 543-3544
NPI assigned
Oct 30, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2024

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

Authorized official

Name
Matthew Kociola
Title
Cfo
Phone
(724) 543-8500

Specialties & licenses 1

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

Addresses

Primary practice location

260 S Jefferson St
Kittanning, PA 16201-2422

Mailing address

1 Nolte Dr
Kittanning, PA 16201-7111
Phone (724) 543-8500

Other names 1

  • Armstrong Primary Care Center Franklin Village Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100806000006 PA Part B Supplier - Clinic/Group Practice 3577696897 Receives reassigned benefits from 40 practitioners
25 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Kittanning, PA; Sarver, PA; New Bethlehem, PA; Natrona Heights, PA

Other NPIs on the same Medicare enrollment 25

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

View all 25

National Provider Directory

National Provider Directory

Locations

198 West Gate Dr
Ste 101A
Kittanning, PA 16201
Phone (724) 543-1735

Practitioners & affiliated clinicians

Practitioners 2

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": "1509321600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724889600000",
    "number": "1831601962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 NOLTE DR",
            "city": "KITTANNING",
            "state": "PA",
            "postal_code": "162017111",
            "telephone_number": "724-543-8500",
            "fax_number": "724-543-8616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "260 S JEFFERSON ST",
            "city": "KITTANNING",
            "state": "PA",
            "postal_code": "162012422",
            "telephone_number": "724-543-5919",
            "fax_number": "724-543-3544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLADE RUN MEDICAL ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-30",
        "last_updated": "2024-08-29",
        "certification_date": "2024-08-29",
        "status": "A",
        "authorized_official_last_name": "KOCIOLA",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "724-543-8500"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Armstrong Primary Care Center Franklin Village",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Kittanning, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.