NPIMap

Organization Active NPI

Centerville Clinics Inc.

  • Urology Physician
  • Fredericktown, PA
National Provider Identifier
1912988452
Registry record updated Apr 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
Legal business name
CENTERVILLE CLINICS INC.
Practice address
1070 Old National Pike
Fredericktown, PA 15333-2114
Phone
(724) 632-6801
NPI assigned
Nov 10, 2005
Last updated
Apr 17, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2008

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

Authorized official

Name
Mrs. Patricia Martos
Title
Director Personnel/Finance
Phone
(724) 632-6801

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X NU Primary

Addresses

Primary practice location

1070 Old National Pike
Fredericktown, PA 15333-2114

Mailing address

1070 Old National Pike
Fredericktown, PA 15333-2114
Phone (724) 632-6801

Other identifiers 2

IdentifierTypeStateIssuer
1007288440027MedicaidPA
031221OtherPAHGSA - MEDICARE

National Provider Directory

National Provider Directory
Tax ID family
Centerville Clinics Inc66 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 16

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1131580800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208390400000",
    "number": "1912988452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1070 OLD NATIONAL PIKE",
            "city": "FREDERICKTOWN",
            "state": "PA",
            "postal_code": "153332114",
            "telephone_number": "724-632-6801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1070 OLD NATIONAL PIKE",
            "city": "FREDERICKTOWN",
            "state": "PA",
            "postal_code": "153332114",
            "telephone_number": "724-632-6801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTERVILLE CLINICS INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-10",
        "last_updated": "2008-04-17",
        "status": "A",
        "authorized_official_last_name": "MARTOS",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_title_or_position": "DIRECTOR PERSONNEL/FINANCE",
        "authorized_official_telephone_number": "724-632-6801",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007288440027",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HGSA - MEDICARE",
            "identifier": "031221",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fredericktown, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 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.