MOUNT NITTANY MEDICAL CENTER (NPI# 1215102355) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1215102355 |
Entity Type | Organization |
Organization Name | MOUNT NITTANY MEDICAL CENTER |
Other Organization Name | DIABETES FOOT CLINIC |
Practice Address |
120 Radnor Rd State College PA 16801-7970 |
Practice Telephone | 8142317868 |
Practice Fax Number | 8142384169 |
Mailing Telephone | 8142317868 |
Mailing Fax Number | 8142384169 |
Enumeration Date | 2008-04-29 |
Last Update Date | 2008-04-29 |
Authorized Official Name | MR. RICHARD J WISNIEWSKI (SR. VP OF FINANCE AND CFO) |
Authorized Official Telephone | 8142346148 |
Authorized Official Credential | CPA |
Is Organization Subpart | Y |
Parent Organization Name | MOUNT NITTANY MEDICAL CENTER |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 282N00000X | General Acute Care Hospital | 550301 | PA | Hospitals |
State | Issuer | Identifier | Type Code |
---|---|---|---|
PA | 1007466550020 | 05 | |
MEDICARE PROVIDER # | 390268 | 01 |
Other Name | Type Code |
---|---|
Diabetes Foot Clinic | Other Name - Individual/Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1528321015 | Mount Nittany Medical Center | Anesthesiology | 1800 E Park Ave, State College, PA 16803-6709 | 2012-06-19 |
1598930638 | Mount Nittany Medical Center | General Acute Care Hospital | 120 Radnor Rd, State College, PA 16801-7970 | 2008-04-29 |
1235339243 | Mount Nittany Medical Center | Prosthetic/Orthotic Supplier | 120 Radnor Rd, Mnmc - Orthotics, State College, PA 16801-7970 | 2007-07-19 |
1346371507 | Mount Nittany Medical Center | General Acute Care Hospital | 1800 E Park Ave, State College, PA 16803-6701 | 2007-03-08 |
1780752378 | Mount Nittany Medical Center | Clinic/Center | 1800 E Park Ave, State College, PA 16803-6701 | 2006-12-01 |
1780750620 | Mount Nittany Medical Center | Clinic/Center | 1850 E Park Ave, State College, PA 16803-6706 | 2006-11-24 |
1104991801 | Mount Nittany Medical Center | Clinic/Center | 911 University Dr, State College, PA 16801-6626 | 2006-11-21 |
1710958251 | Mount Nittany Medical Center | Psychiatric Unit | 1800 E Park Ave, State College, PA 16803-6701 | 2006-02-01 |
1730173154 | Mount Nittany Medical Center | General Acute Care Hospital | 1800 E Park Ave, State College, PA 16803-6701 | 2005-08-31 |
1912906207 | Mount Nittany Medical Center | Ambulance | 1800 E Park Ave, State College, PA 16803-6701 | 2005-07-19 |
Entity Type | Entity Name | Entity Address |
---|---|---|
System for Award Management (SAM) Entities | MOUNT NITTANY MEDICAL CENTER | 1800 E Park Ave, State College, PA 16803-6709 |
Street Address |
120 RADNOR RD |
City | STATE COLLEGE |
State | PA |
Zip Code | 16801-7970 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1689608127 | Mark R Shaw | Emergency Medicine | 120 Radnor Rd, Ste 100, State College, PA 16801 | 2006-07-10 |
1598930638 | Mount Nittany Medical Center | General Acute Care Hospital | 120 Radnor Rd, State College, PA 16801-7970 | 2008-04-29 |
1245418334 | Mount Nittany Medical Center Health Services Inc | Clinic/Center | 120 Radnor Rd, State College, PA 16801-7970 | 2008-01-31 |
1235339243 | Mount Nittany Medical Center | Prosthetic/Orthotic Supplier | 120 Radnor Rd, Mnmc - Orthotics, State College, PA 16801-7970 | 2007-07-19 |
1437230414 | Stacy Merrow | Physician Assistant | 120 Radnor Rd, Ste 100, State College, PA 16801-7970 | 2006-10-18 |
1215944160 | Christine Louise Tichansky | Emergency Medicine | 120 Radnor Rd, Ste 100, State College, PA 16801-7970 | 2006-08-02 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1851880975 | Creative Reflections Counseling, LLC | Counselor | 315 S Allen St Ste 124b, State College, PA 16801 | 2018-05-03 |
1679097901 | Michelle L Grove | Home Health Aide | 2100 E College Ave Ste B, State College, PA 16801 | 2017-07-28 |
1740702034 | Matthew Ishler | Counselor | 315 S. Allen Street Ste 326, State College, PA 16801 | 2017-07-09 |
1699206300 | Emily Lauer | Specialist/Technologist | 102a Multisport Indoor Facility, State College, PA 16801 | 2017-03-23 |
1740721075 | Luk Devorski | Student in an Organized Health Care Education/Training Program | Rec Hall University Park, Penn State University, State College, PA 16801 | 2017-03-20 |
1013465764 | Pennsylvania Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 201 West Beaver Avenue, State College, PA 16801 | 2016-09-12 |
1740685858 | Mallory L. Miller | Physician Assistant | 100 Radnor Rd Ste 101, State College, PA 16801 | 2014-10-31 |
1386053981 | Christopher Hippenmeyer | Specialist/Technologist | 102a East Area Locker Building, Pennsylvania State University, University Park, PA 16801 | 2014-08-07 |
1982022059 | Christy Sharer | Counselor | 301 S Allen St Ste 106, State College, PA 16801 | 2014-04-04 |
1912250523 | Eva M Letwin | Counselor | 2011 Cato Ave Ste 201, State College, PA 16801 | 2012-10-19 |
Find all providers in zip 16801 |
Taxonomy Code | 282N00000X |
Grouping | Hospitals |
Classification | General Acute Care Hospital |
An acute general hospital is an institution whose primary function is to provide inpatient diagnostic and therapeutic services for a variety of medical conditions, both surgical and non-surgical, to a wide population group. The hospital treats patients in an acute phase of illness or injury, characterized by a single episode or a fairly short duration, from which the patient returns to his or her normal or previous level of activity. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1598930638 | Mount Nittany Medical Center | General Acute Care Hospital | 120 Radnor Rd, State College, PA 16801-7970 | 2008-04-29 |
1699953786 | Mount Nittany Medical Center Health Services, Inc. | General Acute Care Hospital | 1800 E Park Ave, State College, PA 16803-6701 | 2008-01-31 |
1346371507 | Mount Nittany Medical Center | General Acute Care Hospital | 1800 E Park Ave, State College, PA 16803-6701 | 2007-03-08 |
1730173154 | Mount Nittany Medical Center | General Acute Care Hospital | 1800 E Park Ave, State College, PA 16803-6701 | 2005-08-31 |
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1972036739 | New-york Presbyterian Hospital | General Acute Care Hospital | 5104 Butler St, Apt 2, Pittsburgh, PA 15201-2647 | 2017-04-09 |
1740721125 | Geisinger Wyoming Valley | General Acute Care Hospital | 183 Robert St, Nanticoke, PA 18634-2015 | 2017-03-17 |
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1639628043 | Tri-county Hospitalists | General Acute Care Hospital | 560 N 16th St, Apt 1, Philadelphia, PA 19130-4105 | 2016-09-26 |
Find all providers with the same taxonomy |
City | STATE COLLEGE |
Zip Code | 16801 |
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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.