DIVINE PROVIDENCE HOSPITAL OF THE SISTERS OF CHRISTIAN CHARITY (NPI# 1285718312) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285718312 |
| Entity Type | Organization |
| Organization Name | DIVINE PROVIDENCE HOSPITAL OF THE SISTERS OF CHRISTIAN CHARITY |
| Other Organization Name | DIVINE PROVIDENCE HOSPITAL |
| Practice Address |
1100 Grampian Blvd Williamsport PA 17701-1909 |
| Mailing Address |
1205 Grampian Blvd 2nd Floor Williamsport PA 17701-1978 |
| Practice Telephone | 5703268000 |
| Practice Fax Number | 5703268601 |
| Mailing Telephone | 5703268676 |
| Mailing Fax Number | 5703268601 |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2016-07-25 |
| Authorized Official Name | MR. ERIC D POHJALA (EXECUTIVE VICE PRESIDENT CFO, CPO) |
| Authorized Official Telephone | 5703213171 |
| Authorized Official Credential | FHFMA, FACHE |
| Is Organization Subpart | Y |
| Parent Organization Name | DIVINE PROVIDENCE HOSPITAL OF THE SISTERS OF CHRISTIAN CHARITY |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QA1903X |
Clinic/Center Specialization: Ambulatory Surgical |
041001 | PA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | 1007563750013 | 05 | |
| PA | AETNA PIN | 394048 | 01 |
| PA | HEALTH AMERICA PIN | 394048 | 01 |
| PA | BLACK LUNG PROGRAM PIN | 396871 | 01 |
| PA | GEISINGER HEALTH PLAN PIN | 70159 | 01 |
| PA | KEYSTONE MERCY HEALTH PIN | 1066310 | 01 |
| PA | AMERIHEALTH HMO AMER PIN | 20012697 | 01 |
| PA | HEALTH ASSURANCE PIN | 394048 | 01 |
| PA | AMERIHEALTH ADMINSTR PIN | 000070 | 01 |
| PA | BLUE CROSS PIN | 394048 | 01 |
| PA | FIRST PRIORITY HEALTH PIN | 816867 | 01 |
| Other Name | Type Code |
|---|---|
| Divine Providence Hospital | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033394564 | Divine Providence Hospital of The Sisters of Christian Charity | Clinic/Center | 471 Hepburn St, Williamsport, PA 17701-6122 | 2008-01-03 |
| 1023141306 | Divine Providence Hospital of The Sisters of Christian Charity | Nursing Care | 1100 Grampian Blvd, 4 South, Williamsport, PA 17701-1909 | 2007-03-14 |
| 1720162878 | Divine Providence Hospital of The Sisters of Christian Charity | Clinic/Center | 1100 Grampian Blvd, Williamsport, PA 17701-1909 | 2006-10-25 |
| 1861576993 | Divine Providence Hospital of The Sisters of Christian Charity | Clinic/Center | 1100 Grampian Blvd, Williamsport, PA 17701-1909 | 2006-10-25 |
| 1023110459 | Divine Providence Hospital of The Sisters of Christian Charity | Clinic/Center | 21 Susquehanna Valley Mall Drive, Suite D, Selinsgrove, PA 17870 | 2006-09-05 |
| 1104851849 | Divine Providence Hospital of The Sisters of Christian Charity | Clinic/Center | 1100 Grampian Blvd, Williamsport, PA 17701-1909 | 2006-07-11 |
| 1568401743 | Divine Providence Hospital of The Sisters of Christian Charity | Hospice Care, Community Based | 1100 Grampian Blvd, 4 South, Williamsport, PA 17701-1909 | 2006-06-05 |
| 1871548560 | Divine Providence Hospital of The Sisters of Christian Charity | Home Health | 1100 Grampian Blvd, 4 South, Williamsport, PA 17701-1909 | 2006-05-23 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | DIVINE PROVIDENCE HOSPITAL OF THE SISTERS OF CHRISTIAN CHARITY | 1100 Grampian Blvd, Williamsport, PA 17701-1907 |
| Street Address |
1100 GRAMPIAN BLVD |
| City | WILLIAMSPORT |
| State | PA |
| Zip Code | 17701-1909 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902804339 | Jennifer Ellyn Bayer | Nurse Practitioner | 1100 Grampian Blvd, Williamsport, PA 17701-1909 | 2005-07-11 |
| 1225647548 | Justin Silverstrim | Physician Assistant | 1100 Grampian Blvd, Williamsport, PA 17701-1907 | 2020-07-23 |
| 1346862745 | Kyle Creighton Thiel | Nurse Practitioner | 1100 Grampian Blvd, Williamsport, PA 17701-1907 | 2020-05-08 |
| 1598399610 | Jacquelyn Elaine Baker | Social Worker | 1100 Grampian Blvd, Williamsport, PA 17701-1909 | 2020-02-27 |
| 1811531304 | Elizabeth Belz | Physician Assistant | 1100 Grampian Blvd, Williamsport, PA 17701-1907 | 2019-10-29 |
| 1881157618 | Stephanie Herman | Nurse Practitioner | 1100 Grampian Blvd, Williamsport, PA 17701-1909 | 2019-04-09 |
| 1376017947 | Amanda Marie Swanson | Nurse Practitioner | 1100 Grampian Blvd, Williamsport, PA 17701-1909 | 2019-01-17 |
| 1225500770 | Upmc Williamsport | Clinic/Center | 1100 Grampian Blvd, Williamsport, PA 17701-1909 | 2018-12-21 |
| 1649746488 | Upmc Williamsport | Psychiatric Unit | 1100 Grampian Blvd, Williamsport, PA 17701-1909 | 2018-10-19 |
| 1164907226 | Robin Elaine Sammons | Nurse Practitioner | 1100 Grampian Blvd, Williamsport, PA 17701-1909 | 2018-09-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184267809 | Charlene Angella Pitter | Nurse Practitioner | 170 Warren Ave, Williamsport, PA 17701 | 2019-10-25 |
| 1396395299 | Susan E Fetzer | Occupational Therapy Assistant | Upmc Susquehanna,625 West Edwin Street, Williamsport, PA 17701 | 2019-09-13 |
| 1184280984 | Craig Andrew Tuller | Student in an Organized Health Care Education/Training Program | Williamsport Family Medicine Residency, 740 High Street, Suite 4001, Williamsport, PA 17701 | 2019-05-16 |
| 1760048045 | Michael Harvey | Student in an Organized Health Care Education/Training Program | 740 High St. Suite 4001, Williamsport, PA 17701 | 2019-05-13 |
| 1275196008 | Olivia Fladmark | Student in an Organized Health Care Education/Training Program | Williamsport Family Medicine Residency 740 High St, Suite 4001, Williamsport, PA 17701 | 2019-04-17 |
| 1528551231 | Mark Hampton Chiropractic Inc. | Durable Medical Equipment & Medical Supplies | 1111 East 3rd Street, Williamsport, PA 17701 | 2018-06-08 |
| 1548710882 | Central Pennsylvania Rehabilitation Medicine, Inc | Physical Medicine & Rehabilitation | 460 River Ave Ste 1, Williamsport, PA 17701 | 2016-10-11 |
| 1376096784 | Christine Kessler | Physician Assistant | One College Ave, Penna. College of Tech, Pa Program Dif 123, Williamsport, PA 17701 | 2016-08-02 |
| 1629440276 | Matthew Ray Rebuck | Specialist/Technologist | 220 N Reach Rd, Williamsport, PA 17701 | 2015-10-22 |
| 1508237223 | Neihl Williamson | Physician Assistant | 1205 Grampian Blvd Ste 3c, Williamsport, PA 17701 | 2015-10-08 |
| Find all providers in zip 17701 | ||||
| Taxonomy Code | 261QA1903X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Ambulatory Surgical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225500770 | Upmc Williamsport | Clinic/Center | 1100 Grampian Blvd, Williamsport, PA 17701-1909 | 2018-12-21 |
| 1447775770 | Ludwick Laser & Surgery Center, LLC | Clinic/Center | 10212 Governor Lane Blvd Unit 1004, Williamsport, MD 21795-4088 | 2017-08-08 |
| 1386011963 | Mason Dixon Surgery Center LLC | Clinic/Center | 10212 Governor Lane Blvd, Williamsport, MD 21795-4086 | 2015-08-30 |
| 1194930925 | Williamsport Surgery Center,llc | Clinic/Center | 920 Washington Blvd, Williamsport, PA 17701-3632 | 2007-05-14 |
| 1447394523 | Ecker Plastic Surgery Assoc Inc | Clinic/Center | 920 Washington Blvd, Williamsport, PA 17701 | 2007-02-20 |
| 1285719559 | Upmc Williamsport | Clinic/Center | 700 High Street, Williamsport, PA 17701-3198 | 2006-10-26 |
| 1104851849 | Divine Providence Hospital of The Sisters of Christian Charity | Clinic/Center | 1100 Grampian Blvd, Williamsport, PA 17701-1909 | 2006-07-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871108068 | Tilden Ambulatory Surgery Center, LLC | Clinic/Center | 61 Industrial Dr, Hamburg, PA 19526-8768 | 2020-09-14 |
| 1447862834 | Us Cardio Washington LLC | Clinic/Center | 1000 Park Place Dr Ste 201, Washington, PA 15301-2064 | 2020-08-18 |
| 1518575778 | Eye Surgery of The Main Line, LLC | Clinic/Center | 333 E City Avenue, Two Bala Plaza, Bala Cynwyd, PA 19004-1501 | 2020-07-14 |
| 1053934919 | Doylestown Surgery Center, LLC | Clinic/Center | 593 West State Street, Doylestown, PA 18901 | 2020-05-26 |
| 1811534555 | Midlantic Urology Surgery Center, LLC | Clinic/Center | Valley Forge Office Center, Suite 100, 676-656 East Swedesford Road, Wayne, PA 19087 | 2019-12-02 |
| 1750927190 | Hermitage Endoscopy Center Inc | Clinic/Center | 949 N Hermitage Road, Hermitage, PA 16148 | 2019-11-20 |
| 1508400920 | Nazareth Endoscopy Center, LLC | Clinic/Center | 2401 Northampton St Ste 220, Easton, PA 18045-2764 | 2019-10-29 |
| 1235788878 | Integrated Surgical Institute, LLC | Clinic/Center | West Ridge Business Campus, 1001 James Drive, Leesport, PA 19533 | 2019-09-06 |
| 1841759040 | Beaver Valley Ambulatory Surgery Center, LLC | Clinic/Center | 79 Wagner Road, Suite 101, Monaca, PA 15061-2489 | 2019-03-18 |
| 1669931861 | Urology Health Surgery Center, LLC | Clinic/Center | 1974 Sproul Rd Ste 104, Broomall, PA 19008-3402 | 2019-03-18 |
| Find all providers with the same taxonomy | ||||
| City | WILLIAMSPORT |
| Zip Code | 17701 |
Please comment or provide details below to improve the information on DIVINE PROVIDENCE HOSPITAL OF THE SISTERS OF CHRISTIAN CHARITY.
| 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.