REBECCA ANN GONGLOFF (NPI# 1164915591) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164915591 |
| Entity Type | Individual |
| Full Name | REBECCA ANN GONGLOFF |
| Credential | PA-C |
| Practice Address |
871 Beaver Dr Du Bois PA 15801-2511 |
| Mailing Address |
587 Allie Buck Rd Nanty Glo PA 15943-3912 |
| Practice Telephone | 8143750455 |
| Practice Fax Number | 8143752721 |
| Mailing Telephone | 8146157057 |
| Enumeration Date | 2018-06-11 |
| Last Update Date | 2019-02-01 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
MA059901 | PA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
871 BEAVER DR |
| City | DU BOIS |
| State | PA |
| Zip Code | 15801-2511 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124109335 | Gregory James Roscoe | Otolaryngology | 871 Beaver Dr, Du Bois, PA 15801-2511 | 2006-10-17 |
| 1497389092 | Megan Morrow-burkett | Nurse Practitioner | 871 Beaver Dr, Du Bois, PA 15801-2511 | 2020-02-24 |
| 1750835237 | Stacey Johnson | Hearing Instrument Specialist | 871 Beaver Dr, Du Bois, PA 15801-2511 | 2016-08-12 |
| 1972997575 | Ashleigh Valenza | Audiologist | 871 Beaver Dr, Du Bois, PA 15801-2511 | 2015-03-23 |
| 1801165006 | Heidi L Gregg | Nurse Practitioner | 871 Beaver Dr, Du Bois, PA 15801-2511 | 2011-12-19 |
| 1235204611 | Clearfield Jefferson Head and Neck Surgical Associates, Inc. | Audiologist | 871 Beaver Dr, Du Bois, PA 15801-2511 | 2006-11-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215551452 | Grace Polohonki | Counselor | 490 Jefers Street, Dubois, PA 15801 | 2020-06-03 |
| 1144869231 | Richard Lee Kerstetter II | Hearing Instrument Specialist | 124 San Juan Rd, Du Bois, PA 15801 | 2020-01-06 |
| 1700368487 | Holly Noel Knoll | Counselor | 490 Jeffers Street, Dubois, PA 15801 | 2018-08-30 |
| 1992298160 | Dubois Regional Medical Center | Family Medicine | 145 Hospital Ave Ste 315, Du Bois, PA 15801 | 2018-06-12 |
| 1154814846 | Sara Beth Stone | Dietitian, Registered | 16288 Treasure Lk, Du Bois, PA 15801 | 2018-06-07 |
| 1942790779 | Wendi Dawn Wenzel | Counselor | 490 Jeffers St., Dubois, PA 15801 | 2018-05-17 |
| 1144748443 | Nancy Foradora | Massage Therapist | 200 Narrows Creek Park Road, Dubois, PA 15801 | 2017-09-07 |
| 1679098891 | Deborah Jean Mitchell | Hearing Instrument Specialist | 900 Beaver Drive, Dubois, PA 15801 | 2017-08-09 |
| 1861937757 | Shaun M Kanouff | Counselor | 100 Caldwell Dr., Dubois, PA 15801 | 2016-12-30 |
| 1164897740 | Drayer Physical Therapy Institute LLC | Physical Therapist | 873 Beaver Drive, Dubois, PA 15801 | 2015-12-08 |
| Find all providers in zip 15801 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710470224 | Marissa Zocco | Physician Assistant | 145 Hospital Ave Ste 204, Du Bois, PA 15801-1464 | 2018-06-08 |
| 1396112926 | Conda Joseph Weimer | Physician Assistant | 655 E Dubois Ave, Du Bois, PA 15801-3605 | 2015-08-31 |
| 1477756286 | Dorothy Miriam Brager | Physician Assistant | Clearfield Jefferson Community Mental Health Center Inc, 100 Caldwell Dr., Du Bois, PA 15801 | 2007-06-08 |
| 1942833538 | Kimberly Erin Miller | Physician Assistant | 100 Hospital Ave, Du Bois, PA 15801-1440 | 2020-02-21 |
| 1215418470 | Michael Christopher Blose | Physician Assistant | 100 Hospital Ave, Du Bois, PA 15801-1440 | 2018-08-27 |
| 1194217778 | Sydney Marie Soberdash | Physician Assistant | 621 S Main St, Du Bois, PA 15801-1413 | 2018-05-31 |
| 1316467038 | Morgan Diane Miksich | Physician Assistant | 100 Hospital Ave, Du Bois, PA 15801-1440 | 2017-06-23 |
| 1053714642 | Ashley Nicole Bertram | Physician Assistant | 529 Sunflower Dr, Du Bois, PA 15801-2378 | 2014-09-26 |
| 1629482161 | Chelsea Lee Mcnutt | Physician Assistant | 145 Hospital Ave, Suite 215, Du Bois, PA 15801-1462 | 2014-06-12 |
| 1700121258 | Margo Puhala | Physician Assistant | 33 Beaver Dr, Ste 1, Du Bois, PA 15801-2434 | 2012-12-10 |
| Find all providers in DU BOIS | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.