NPIMap

Organization Active NPI

Dubois Regional Medical Center - Penn Highlands Family Medicine

Doing business as Penn Highlands DuBois

  • Family Medicine Physician
  • Du Bois, PA
National Provider Identifier
1841675469
Registry record updated Aug 25, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
DUBOIS REGIONAL MEDICAL CENTER - PENN HIGHLANDS FAMILY MEDICINE
Doing business as
Penn Highlands DuBois
Practice address
145 Hospital Ave
Suite 205
Du Bois, PA 15801-1462
Phone
(814) 371-0373
NPI assigned
Jul 24, 2015
Organization subpart
Yes
Parent organization
PENN HIGHALNDS HEALTHCAREAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 25, 2015

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

Authorized official

Name
Brian Kline
Title
Cfo
Phone
(814) 375-6377

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X

Addresses

Primary practice location

145 Hospital Ave
Suite 205
Du Bois, PA 15801-1462

Mailing address

100 Hospital Ave
Business Office
Du Bois, PA 15801-1440

Other identifiers 1

IdentifierTypeStateIssuer
100774088MedicaidPA

Other names 1

  • Penn Highlands DuBois Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Dubois Regional Medical Center - Penn Highlands Family Medicine123 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1437696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1440460800000",
    "number": "1841675469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 HOSPITAL AVE",
            "address_2": "BUSINESS OFFICE",
            "city": "DU BOIS",
            "state": "PA",
            "postal_code": "158011440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 HOSPITAL AVE",
            "address_2": "SUITE 205",
            "city": "DU BOIS",
            "state": "PA",
            "postal_code": "158011462",
            "telephone_number": "814-371-0373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DUBOIS REGIONAL MEDICAL CENTER - PENN HIGHLANDS FAMILY MEDICINE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PENN HIGHALNDS HEALTHCARE",
        "enumeration_date": "2015-07-24",
        "last_updated": "2015-08-25",
        "status": "A",
        "authorized_official_last_name": "KLINE",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "814-375-6377"
    },
    "taxonomies": [
        {
            "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
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100774088",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Penn Highlands DuBois",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Du Bois, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2015; 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.