Concussion Management Center of Central PA, LLC

Primary specialty

Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X

Legal business name

CONCUSSION MANAGEMENT CENTER OF CENTRAL PA, LLC

Practice address

111 Nason Dr
Suite 104
Roaring Spring, PA 16673-1212

Phone

(814) 224-6096

Fax

(814) 224-6095

NPI assigned

Feb 27, 2013

Organization subpart

No

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

Authorized official

Name

Dr. John A Baker, DO

Title

Physician

Phone

(814) 224-6096

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1361923200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1361923200000",
    "number": "1891035937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 NASON DR",
            "address_2": "SUITE 104",
            "city": "ROARING SPRING",
            "state": "PA",
            "postal_code": "166731212",
            "telephone_number": "814-224-6096",
            "fax_number": "814-224-6095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 NASON DR",
            "address_2": "SUITE 104",
            "city": "ROARING SPRING",
            "state": "PA",
            "postal_code": "166731212",
            "telephone_number": "814-224-6096",
            "fax_number": "814-224-6095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONCUSSION MANAGEMENT CENTER OF CENTRAL PA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-27",
        "last_updated": "2013-02-27",
        "status": "A",
        "authorized_official_last_name": "BAKER",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "814-224-6096",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine, Sports Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Taylor Buchanan, PT
• Brian Kent Burket, LPC
• Kelly Lee Bushore, PHYSICAL THERAPIST
• Central Pennsylvania Imaging, PC
• Shawn A Claycomb, D.C.
• Jennifer L Covaleski, PT
• Cove Family Practice, Inc.
• Cove Home Care, LLC
• Cove Radiology Associates, PC
• Cove Surgical Associates LTD

• Sports Medicine (Family Medicine) Physician in Roaring Spring, PA
• Providers in Roaring Spring, PA by specialty
• Sports Medicine (Family Medicine) Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2013; 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.