NPIMap

Organization Active NPI

Dubois Regional Medical Center

  • Registered Dietitian
  • Du Bois, PA
National Provider Identifier
1851794549
Registry record updated Aug 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
DN002090 Issued in PA
Legal business name
DUBOIS REGIONAL MEDICAL CENTER
Doing business as
Penn Highlands DuBois
Practice address
145 Hospital Ave Ste 105
Du Bois, PA 15801-1463
Phone
(814) 375-3890
Fax
(814) 375-3893
NPI assigned
Oct 8, 2014
Organization subpart
Yes
Parent organization
PENN HIGHLANDS HEALTHCAREAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 8, 2017

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

Authorized official

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered DietitianGroup: 193200000X MULTI-SPECIALTY GROUP 133V00000X DN002090 PA Primary

Addresses

Primary practice location

145 Hospital Ave Ste 105
Du Bois, PA 15801-1463

Mailing address

100 Hospital Ave
Du Bois, PA 15801-1440
Phone (814) 375-6183

Other identifiers 1

IdentifierTypeStateIssuer
3093208OtherPAHIGHMARK ASSIGNMENT ACCOUNT

Other names 1

  • Penn Highlands DuBois Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160929000743 PA Part B Supplier - Hospital Department(S) 5890689715 Practice locations: Clearfield, PA; Dubois, PA; Philipsburg, PA; Punxsutawney, PA; Saint Marys, PA; Brookville, PA

National Provider Directory

National Provider Directory
Part of
Penn Highlands Healthcare

Locations

271 Railroad St
Ph
Philipsburg, PA 16866
Phone (814) 375-3890

551 W Mahoning St
Ph
Punxsutawney, PA 15767
Phone (814) 375-3890

Ownership & related parties

All facility ownership & control disclosures 4

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Penn Highlands BrookvilleBrookville, PA, CCN 391312 Hospital Operational/Managerial Control Sep 26, 2007
Dr Arthur Clifton McKinley Health CenterBrookville, PA, CCN 395550 Skilled nursing facility 5% Or Greater Indirect Ownership Interest
Operational/Managerial Control
Adp of the SNF		 Dec 31, 2021
Jan 1, 2024
Sep 25, 2025
Penn Highlands Jefferson ManorBrookville, PA, CCN 395626 Skilled nursing facility 5% Or Greater Indirect Ownership Interest
Adp of the SNF		 Apr 1, 2019
Dec 9, 2025
Penn Highlands BrookvillePhilipsburg, PA, CCN 393430 Rural health clinic Operational/Managerial Control (100%) Oct 1, 2011

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.

NPI Registry JSON

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

{
    "created_epoch": "1412726400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1502150400000",
    "number": "1851794549",
    "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": "814-375-6183",
            "fax_number": "814-372-2718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 HOSPITAL AVE STE 105",
            "city": "DU BOIS",
            "state": "PA",
            "postal_code": "158011463",
            "telephone_number": "814-375-3890",
            "fax_number": "814-375-3893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DUBOIS REGIONAL MEDICAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PENN HIGHLANDS HEALTHCARE",
        "enumeration_date": "2014-10-08",
        "last_updated": "2017-08-08",
        "status": "A",
        "authorized_official_last_name": "KLINE",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "814-375-6377"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dietitian, Registered",
            "state": "PA",
            "license": "DN002090",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK ASSIGNMENT ACCOUNT",
            "identifier": "3093208",
            "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

Verify at the official NPI Registry.