NPIMap

Organization Active NPI

Upmc Bedford Memorial

  • Internal Medicine Physician
  • Everett, PA
National Provider Identifier
1992853923
Registry record updated Dec 4, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
650501 Issued in PA
Legal business name
UPMC BEDFORD MEMORIAL
Practice address
10455 Lincoln Hwy
Everett, PA 15537-7046
Phone
(814) 623-6161
Fax
(814) 623-3535
NPI assigned
Jan 8, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2007

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

Authorized official

Name
Mr. Roger Winn
Title
Ceo
Phone
(814) 623-1104

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 650501 PA Primary

Addresses

Primary practice location

10455 Lincoln Hwy
Everett, PA 15537-7046

Mailing address

10455 Lincoln Hwy
Everett, PA 15537-7046
Phone (814) 623-6161

Other identifiers 1

IdentifierTypeStateIssuer
1007460470026MedicaidPA

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196726400000",
    "number": "1992853923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10455 LINCOLN HWY",
            "city": "EVERETT",
            "state": "PA",
            "postal_code": "155377046",
            "telephone_number": "814-623-6161",
            "fax_number": "814-623-3535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10455 LINCOLN HWY",
            "city": "EVERETT",
            "state": "PA",
            "postal_code": "155377046",
            "telephone_number": "814-623-6161",
            "fax_number": "814-623-3535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UPMC BEDFORD MEMORIAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-08",
        "last_updated": "2007-12-04",
        "status": "A",
        "authorized_official_last_name": "WINN",
        "authorized_official_first_name": "ROGER",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "814-623-1104",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "650501",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007460470026",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Everett, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2007; 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.