NPIMap

Organization Active NPI

Mount Nittany Medical Center

  • Land Ambulance
  • State College, PA
National Provider Identifier
1912906207
Registry record updated Jul 27, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Land AmbulanceTaxonomy code 3416L0300X
License
02283 Issued in PA
Legal business name
MOUNT NITTANY MEDICAL CENTER
Practice address
1800 E Park Ave
State College, PA 16803-6701
Phone
(814) 231-7024
NPI assigned
Jul 19, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2007

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

Authorized official

Name
Rich Kelley
Title
Als Supervisor
Phone
(814) 231-7024

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Land Ambulance 3416L0300X 02283 PA Primary

Addresses

Primary practice location

1800 E Park Ave
State College, PA 16803-6701

Mailing address

PO Box 726
New Cumberland, PA 17070-0726
Phone (717) 214-6018

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060712000045 PA Part B Supplier - Ambulance Service Supplier 2365353364 Practice locations: State College, PA

Other NPIs with the same Medicare PAC ID 5

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

National Provider Directory

National Provider Directory
Tax ID family
Card Centre Comm Hosp21 organizations share this tax ID, including this one

Other organizations with this tax ID 20

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

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1121731200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1185494400000",
    "number": "1912906207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 726",
            "city": "NEW CUMBERLAND",
            "state": "PA",
            "postal_code": "170700726",
            "telephone_number": "717-214-6018",
            "fax_number": "717-214-6020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 E PARK AVE",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168036701",
            "telephone_number": "814-231-7024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNT NITTANY MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-19",
        "last_updated": "2007-07-27",
        "status": "A",
        "authorized_official_last_name": "KELLEY",
        "authorized_official_first_name": "RICH",
        "authorized_official_title_or_position": "ALS SUPERVISOR",
        "authorized_official_telephone_number": "814-231-7024"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "PA",
            "license": "02283",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in State College, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.