Prodigy Dialysis

Primary specialty

End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X

License

MD042825E Issued in PA

Legal business name

PRODIGY DIALYSIS

Practice address

387 Theatre Rd
Carrolltown, PA 15722-7805

Phone

(814) 539-0798

Fax

(814) 536-4751

NPI assigned

Feb 29, 2012

Last updated

Sep 25, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Cory Yacynych

Title

Practice Manager

Phone

(814) 299-4676

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1330473600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1348531200000",
    "number": "1902170525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "88 OSBORNE ST",
            "city": "JOHNSTOWN",
            "state": "PA",
            "postal_code": "159054146",
            "telephone_number": "814-539-0798",
            "fax_number": "814-536-4751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "387 THEATRE RD",
            "city": "CARROLLTOWN",
            "state": "PA",
            "postal_code": "157227805",
            "telephone_number": "814-539-0798",
            "fax_number": "814-536-4751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRODIGY DIALYSIS",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-29",
        "last_updated": "2012-09-25",
        "status": "A",
        "authorized_official_last_name": "YACYNYCH",
        "authorized_official_first_name": "CORY",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "814-299-4676"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "PA",
            "license": "MD042825E",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Steve Robert Pagano Jr., D.C.
• Christopher B Paronish, MD
• Patton Family Medical Center Inc
• Patton Family Medical Center, Christopher Paronish M.D., LLC
• Patton Family Medical Center, Christopher Paronish MD, LLC
• Denise Rematt, PT
• Rezk Pharmacy LLC
• Rhonda a Wendekier
• Christine M Rohanna, DO
• Barbara Jo Sharbaugh, RPH

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Carrolltown, PA
• Providers in Carrolltown, PA by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2012; 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.