NPIMap

Organization Active NPI

Dubois Regional Medical Center

  • Family Medicine Physician
  • Brookville, PA
National Provider Identifier
1922233147
Registry record updated Apr 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
DUBOIS REGIONAL MEDICAL CENTER
Practice address
90 Hospital Rd
Suite 200
Brookville, PA 15825-1382
Phone
(814) 849-1874
Fax
(814) 849-1444
NPI assigned
May 18, 2009
Organization subpart
Yes
Parent organization
PENN HIGHLANDS HEALTHCAREAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 8, 2016

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

Authorized official

Name
Brian S Kline
Title
Authorized Official, VP, & Cfo
Phone
(814) 375-6377

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X PA Primary
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X

Addresses

Primary practice location

90 Hospital Rd
Suite 200
Brookville, PA 15825-1382

Mailing address

100 Hospital Avenue
Dubois, PA 15801-1440
Phone (814) 375-4200

Other identifiers 1

IdentifierTypeStateIssuer
1007740880169MedicaidPA

Other names 1

  • Penn Highlands Dubois Family Med-Prusakowski Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Patrick Shilala123 organizations share this tax ID, including this one
Part of
Penn Highlands Healthcare

Organizations with this tax ID in the same state 24

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

View all 24

Ownership & related parties

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.

NPI Registry JSON

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

{
    "created_epoch": "1242604800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1460073600000",
    "number": "1922233147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 HOSPITAL AVENUE",
            "city": "DUBOIS",
            "state": "PA",
            "postal_code": "158011440",
            "telephone_number": "814-375-4200",
            "fax_number": "814-375-4232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 HOSPITAL RD",
            "address_2": "SUITE 200",
            "city": "BROOKVILLE",
            "state": "PA",
            "postal_code": "158251382",
            "telephone_number": "814-849-1874",
            "fax_number": "814-849-1444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DUBOIS REGIONAL MEDICAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PENN HIGHLANDS HEALTHCARE",
        "enumeration_date": "2009-05-18",
        "last_updated": "2016-04-08",
        "status": "A",
        "authorized_official_last_name": "KLINE",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL, VP, & CFO",
        "authorized_official_telephone_number": "814-375-6377"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "PA",
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007740880169",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Penn Highlands Dubois Family Med-Prusakowski",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Brookville, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2016; 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.