NPIMap

Organization Active NPI

Geisinger Clinic

  • Dermatology Physician
  • Lock Haven, PA
National Provider Identifier
1881700755
Registry record updated Jun 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
GEISINGER CLINIC
Practice address
955 Bellefonte Ave
Lock Haven, PA 17745
Phone
(570) 893-6322
NPI assigned
Aug 22, 2006
Last updated
Jun 30, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2008

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

Authorized official

Name
Kenneth Holdren
Title
Cao
Phone
(570) 271-5490

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU
Nurse Practitioner 363L00000X NU
Dermatology Physician 207N00000X NU Primary

Addresses

Primary practice location

955 Bellefonte Ave
Lock Haven, PA 17745

Mailing address

100 N Academy Ave
Danville, PA 17822-3034
Phone (570) 271-6211

Other identifiers 1

IdentifierTypeStateIssuer
527058OtherPAHIGHMARK BS #

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1156204800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214784000000",
    "number": "1881700755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N ACADEMY AVE",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178223034",
            "telephone_number": "570-271-6211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "955 BELLEFONTE AVE",
            "city": "LOCK HAVEN",
            "state": "PA",
            "postal_code": "17745",
            "telephone_number": "570-893-6322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEISINGER CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-22",
        "last_updated": "2008-06-30",
        "status": "A",
        "authorized_official_last_name": "HOLDREN",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_title_or_position": "CAO",
        "authorized_official_telephone_number": "570-271-5490"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BS #",
            "identifier": "527058",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lock Haven, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2008; 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.