Keller Army Community Hospital

Primary specialty

Rehabilitation Hospital UnitTaxonomy code 273Y00000X

License

MD013443E Issued in PA

Legal business name

KELLER ARMY COMMUNITY HOSPITAL

Practice address

11 Hap Arnold Blvd
Health Clinic
Tobyhanna, PA 18466-5002

Phone

(570) 895-6242

Fax

(570) 895-6783

NPI assigned

Mar 2, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Italo M Bastianelli, MD

Title

DCCS

Phone

(854) 938-6940

Specialties & licenses 1

Addresses

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Keller Army Community Hospital

  • Military/U.S. Coast Guard Outpatient Clinic/Center
  • Tobyhanna, PA
  • NPI 1225243181
  NPPES parent name

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

{
    "created_epoch": "1141257600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1861469355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 HAP ARNOLD BLVD",
            "address_2": "HEALTH CLINIC",
            "city": "TOBYHANNA",
            "state": "PA",
            "postal_code": "184665002",
            "telephone_number": "570-895-6242",
            "fax_number": "570-895-6783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 HAP ARNOLD BLVD",
            "address_2": "HEALTH CLINIC",
            "city": "TOBYHANNA",
            "state": "PA",
            "postal_code": "184665002",
            "telephone_number": "570-895-6242",
            "fax_number": "570-895-6783"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KELLER ARMY COMMUNITY HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BASTIANELLI",
        "authorized_official_first_name": "ITALO",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "DCCS",
        "authorized_official_telephone_number": "854-938-6940",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "273Y00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Unit",
            "state": "PA",
            "license": "MD013443E",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie A. Jennings, CRNP
• Heath Jones, MOTRL
• Anisha Nicole Jongay-Hudson
• Kristin Marie Kachmar, LSW
• Keller Army Community Hospital
• Marc M. Keuler, MD
• James T Kincel Jr., PA-C
• Louise Knight-Long, LSW
• Kym Kids Professional Services, Inc
• Diane Latosek, RPH

• Rehabilitation Hospital Unit in Tobyhanna, PA
• Providers in Tobyhanna, PA by specialty
• Rehabilitation Hospital Unit in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.