NPIMap

Organization Active NPI

Olean General Hospital

Doing business as Bradford Regional Medical Center

  • Ambulatory Surgical Clinic/Center
  • Bradford, PA
National Provider Identifier
1871630897
Registry record updated Oct 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
541201 Issued in PA
Legal business name
OLEAN GENERAL HOSPITAL
Doing business as
Bradford Regional Medical Center
Practice address
116 Interstate Pkwy
Bradford, PA 16701-1036
Phone
(814) 368-4143
Fax
(814) 368-5722
NPI assigned
Jan 31, 2007
Last updated
Oct 10, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2023

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

Authorized official

Name
Jill M. Owens, MD
Title
Ceo
Phone
(716) 373-2600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X 541201 PA Primary

Addresses

Primary practice location

116 Interstate Pkwy
Bradford, PA 16701-1036

Mailing address

116 Interstate Pkwy
Bradford, PA 16701-1036
Phone (814) 368-4143

Other identifiers 1

IdentifierTypeStateIssuer
1007507650041MedicaidPA

Other names 1

  • Bradford Regional Medical Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Rebecca Scheiterle MD17 organizations share this tax ID, including this one

Other organizations with this tax ID 16

Organizations that report the same tax identification number in the National Provider Directory.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696896000000",
    "number": "1871630897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 INTERSTATE PKWY",
            "city": "BRADFORD",
            "state": "PA",
            "postal_code": "167011036",
            "telephone_number": "814-368-4143",
            "fax_number": "814-368-5722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 INTERSTATE PKWY",
            "city": "BRADFORD",
            "state": "PA",
            "postal_code": "167011036",
            "telephone_number": "814-368-4143",
            "fax_number": "814-368-5722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLEAN GENERAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-31",
        "last_updated": "2023-10-10",
        "certification_date": "2023-10-10",
        "status": "A",
        "authorized_official_last_name": "OWENS",
        "authorized_official_first_name": "JILL",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "716-373-2600",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "PA",
            "license": "541201",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007507650041",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bradford Regional Medical Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Bradford Regional Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bradford, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2023; 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.