Excela Health Physician Practices

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD427026 Issued in PA

Legal business name

EXCELA HEALTH PHYSICIAN PRACTICES

Practice address

2616 Memorial Blvd
Suite B
Connellsville, PA 15425-1418

Phone

(724) 628-9350

Fax

(724) 628-9353

NPI assigned

Jul 16, 2006

Organization subpart

Yes

Parent organization

EXCELA HEALTH PHYSICIAN PRACTICES, INCAs reported in NPPES

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

Authorized official

Name

John M Sphon

Title

Vice President

Phone

(724) 830-8500

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Excela Health Connellsville Family Practice-R. Conn, MD Other name

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Part of

Excela Health Connellsville Internal Med-Dr Tiberio

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Excela Health Physician Practices, Inc.

  • Multi-Specialty Clinic/Center
  • Greensburg, PA
  • NPI 1316072846
  NPPES parent name

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

{
    "created_epoch": "1153008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205366400000",
    "number": "1912924804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2616 MEMORIAL BLVD",
            "address_2": "SUITE B",
            "city": "CONNELLSVILLE",
            "state": "PA",
            "postal_code": "154251418",
            "telephone_number": "724-628-9350",
            "fax_number": "724-628-9353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2616 MEMORIAL BLVD",
            "address_2": "SUITE B",
            "city": "CONNELLSVILLE",
            "state": "PA",
            "postal_code": "154251418",
            "telephone_number": "724-628-9350",
            "fax_number": "724-628-9353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXCELA HEALTH PHYSICIAN PRACTICES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EXCELA HEALTH PHYSICIAN PRACTICES, INC",
        "enumeration_date": "2006-07-16",
        "last_updated": "2008-03-13",
        "status": "A",
        "authorized_official_last_name": "SPHON",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "724-830-8500"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD427026",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0015621860064",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Excela Health Connellsville Family Practice-R. Conn, MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Emergency Medicine Physicians of Fayette County LTD
• Emergency Solutions Highlands Inc
• Albert Kelly Enany II, MD
• Danielle Lee Etling, RPH
• Excela Health Connellsville Internal Med-Dr. Tiberio
• Excela Health Physician Practices, Inc
• Fayette EMS
• Fayette Medical Associates Inc
• Fayette Physician Network Inc
• Fayette Physician Network Inc

• Family Medicine Physician in Connellsville, PA
• Providers in Connellsville, PA by specialty
• Family Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2008; 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.