NPIMap

Organization Active NPI

Keystone Rural Health Center

Doing business as Keystone Pediatrics Fifth Avenue

  • Federally Qualified Health Center (FQHC)
  • Chambersburg, PA
National Provider Identifier
1861785669
Registry record updated Jun 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
KEYSTONE RURAL HEALTH CENTER
Doing business as
Keystone Pediatrics Fifth Avenue
Practice address
830 5TH Ave Ste 103
Chambersburg, PA 17201-4224
Phone
(717) 709-7950
Fax
(717) 263-8898
NPI assigned
May 26, 2011
Last updated
Jun 17, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
KEYSTONE RURAL HEALTH CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 17, 2026

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

Authorized official

Name
Ms. Joanne Cochran
Title
Ceo
Phone
(717) 709-7906

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X NU Primary

Addresses

Primary practice location

830 5TH Ave Ste 103
Chambersburg, PA 17201-4224

Mailing address

111 Chambers Hill Dr Ste 200
Chambersburg, PA 17201-7304
Phone (717) 709-7922

Other names 2

  • Keystone Pediatrics Fifth Avenue Doing business as
  • Keystone Pediatrics Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040329000065 PA Part B Supplier - Clinic/Group Practice 5496663312 Receives reassigned benefits from 141 practitioners
24 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Waynesboro, PA; Chambersburg, PA
O20100506000109 PA Part A Provider - Federally Qualified Health Center (FQHC) 5496663312 1 other NPI on this enrollment
Practice locations: Chambersburg, PA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1861785669. Details of each certification follow.

Federally qualified health center certification: CCN 391920

Legal name
KEYSTONE RURAL HEALTH CENTER
Doing business as
KEYSTONE PEDIATRICS
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Mar 5, 2003
Last certification
Mar 5, 2003
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Mar 18, 1987 in PA
Enrollment address
830 Fifth Ave
Suite 103
Chambersburg, PA 17201-4224

Other NPIs with the same Medicare PAC ID 22

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 22

Other NPIs on the same Medicare enrollment 19

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

View all 19

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
39D0186962Keystone Pediatrics830 5TH Ave Suite 103, Chambersburg, PA 17201Certificate of waiverJan 18, 2028

National Provider Directory

National Provider Directory
Part of
Keystone HLTH Ctr

Ownership & related parties

All disclosed owners & managing parties 14

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Mark Smith Individual Corporate Officer May 1, 2024
Muhammad Amer Chaudhry Individual Corporate Officer Jan 1, 2024
Carrie Gray Individual Corporate OfficerChair Dec 31, 2021
Michael Kugler Individual Corporate OfficerBoard Member Jan 1, 2015
Jenna Kaczmarek Individual Corporate Officer Jan 1, 2024
Timothy Henry Individual Corporate Officer Dec 31, 2021
Scott Brown Individual Corporate Director Jun 2, 2021
Joanne L Cochran Individual Corporate DirectorCeo Mar 18, 1987
W-2 Managing EmployeeCeo Mar 18, 1987
William a Morgan Individual Corporate OfficerBoard Member Jan 1, 2015
Karen Pickenheim Johnston Individual Corporate OfficerSecretary Jan 1, 2015
Wanda Dietrich Individual Corporate Officer Jul 4, 2024
Virginia Harriger Individual Corporate Director Nov 3, 2021
Sila Alegret-Bartel Individual Corporate OfficerBoard Member Jan 1, 2015
Brittany Henderson Individual Corporate Director Jan 5, 2022

Practitioners & affiliated clinicians

Practitioners 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1306368000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1781654400000",
    "number": "1861785669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 CHAMBERS HILL DR STE 200",
            "city": "CHAMBERSBURG",
            "state": "PA",
            "postal_code": "172017304",
            "telephone_number": "717-709-7922",
            "fax_number": "717-263-2055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 5TH AVE STE 103",
            "city": "CHAMBERSBURG",
            "state": "PA",
            "postal_code": "172014224",
            "telephone_number": "717-709-7950",
            "fax_number": "717-263-8898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEYSTONE RURAL HEALTH CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "KEYSTONE RURAL HEALTH CENTER",
        "enumeration_date": "2011-05-26",
        "last_updated": "2026-06-17",
        "certification_date": "2026-06-17",
        "status": "A",
        "authorized_official_last_name": "COCHRAN",
        "authorized_official_first_name": "JOANNE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "717-709-7906",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Keystone Pediatrics Fifth Avenue",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Keystone Pediatrics",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Chambersburg, PA

Sources for this page

Verify at the official NPI Registry.