GEISINGER WYOMING VALLEY MEDICAL CENTER (NPI# 1649568403) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649568403 |
| Entity Type | Organization |
| Organization Name | GEISINGER WYOMING VALLEY MEDICAL CENTER |
| Practice Address |
114 Lt Michael Cleary Dr Dallas PA 18612-1649 |
| Mailing Address |
100 N Academy Ave Danville PA 17822-4903 |
| Practice Telephone | 5706752000 |
| Mailing Telephone | 5702715555 |
| Enumeration Date | 2011-07-14 |
| Last Update Date | 2020-01-30 |
| Authorized Official Name | CINDY MULL (DIRECTOR) |
| Authorized Official Telephone | 5702716144 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | MEDICARE | 390270 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770953994 | Geisinger Wyoming Valley Medical Center | General Acute Care Hospital | 35 South Mountain Blvd, Mountain Top, PA 18707 | 2015-09-30 |
| 1104292960 | Geisinger Wyoming Valley Medical Center | Radiology | 42 North Main St, Pittston, PA 18640 | 2015-08-17 |
| 1205197894 | Geisinger Wyoming Valley Medical Center | Durable Medical Equipment & Medical Supplies | 1175 East Mountain Blvd, Wilkes Barre, PA 18702-7906 | 2012-05-31 |
| 1447538640 | Geisinger Wyoming Valley Medical Center | Clinic/Center | 620 Baltimore Dr, Wilkes Barre, PA 18702-7959 | 2011-07-22 |
| 1093001653 | Geisinger Wyoming Valley Medical Center | Clinic/Center | 270 S River St, Plains, PA 18705-1191 | 2011-06-22 |
| 1942769393 | Geisinger Wyoming Valley Medical Center | Pharmacy | 1000 E Mountain Blvd, Wilkes Barre, PA 18711-0027 | 2019-03-15 |
| 1437551868 | Geisinger Wyoming Valley Medical Center | Durable Medical Equipment & Medical Supplies | 1155 E Mountain Blvd, Wilkes Barre, PA 18702-7906 | 2014-09-17 |
| 1881980803 | Geisinger Wyoming Valley Medical Center | Clinic/Center | 675 Baltimore Dr, Wilkes Barre, PA 18702-7900 | 2011-06-28 |
| 1669768214 | Geisinger Wyoming Valley Medical Center | Clinic/Center | 110 Trieble Rd, Tunkhannock, PA 18657-3816 | 2011-06-22 |
| 1265728810 | Geisinger Wyoming Valley Medical Center | Clinic/Center | 1130 Highway 315, Wilkes Barre, PA 18702-6952 | 2011-06-22 |
| Street Address |
114 LT MICHAEL CLEARY DR |
| City | DALLAS |
| State | PA |
| Zip Code | 18612-1649 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063472389 | Michael A. Kovalick | Family Medicine | 114 Lt Michael Cleary Dr, Dallas, PA 18612-1649 | 2006-03-23 |
| 1184260184 | Lindsay Theresa Denion | Family Medicine | 114 Lt Michael Cleary Dr, Dallas, PA 18612-1649 | 2019-11-25 |
| 1720623523 | Courtney Mackrell | Nurse Practitioner | 114 Lt Michael Cleary Dr, Dallas, PA 18612-1649 | 2019-11-15 |
| 1962944041 | Mallory Turner | Physician Assistant | 114 Lt Michael Cleary Dr, Dallas, PA 18612-1649 | 2016-11-07 |
| 1598113045 | Raymond Alan Besecker | Pharmacist | 114 Lt Michael Cleary Dr, Dallas, PA 18612-1649 | 2016-05-25 |
| 1609220961 | Kathryn Olivia Gussman | Family Medicine | 114 Lt Michael Cleary Dr, Dallas, PA 18612-1649 | 2016-04-22 |
| 1023407244 | Aimee Detweiler | Nurse Practitioner | 114 Lt Michael Cleary Dr, Dallas, PA 18612-1649 | 2015-01-12 |
| 1881946770 | Lindsay Margaret Stavish | Physician Assistant | 114 Lt Michael Cleary Dr, Dallas, PA 18612-1649 | 2012-10-03 |
| 1679820583 | Matthew George Perry | Physician Assistant | 114 Lt Michael Cleary Dr, Dallas, PA 18612-1649 | 2012-08-09 |
| 1912262759 | Matthew Evan Joseph | Family Medicine | 114 Lt Michael Cleary Dr, Dallas, PA 18612-1649 | 2012-07-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487009882 | Jacqueline Patricia O'brien | Occupational Therapist | 345 Lake Louise Rd, Dallas, PA 18612 | 2016-05-04 |
| 1164772927 | Katie M Ferguson | Pharmacist | 26 Dallas Shopping Center Memorial Highway, Dallas, PA 18612 | 2012-09-19 |
| 1619235892 | Crista Zern | Physical Therapist | 4 East Center Hill Road, Dallas, PA 18612 | 2012-04-25 |
| 1336423631 | Angela Mary Evans | Nurse Practitioner | 301 Lake Street, Misericordia University's Health & Wellness Center, Dallas, PA 18612 | 2011-10-05 |
| 1376835868 | Peter Frederick Casterline | Surgery | 5 Old Well Lane, Dallas, PA 18612 | 2011-05-03 |
| 1336386051 | Judy A Williams | Speech-Language Pathologist | 368 Tioga Avenue, Kingston, PA 18612 | 2009-01-16 |
| 1013195015 | Joseph John Kowalski | Psychiatry & Neurology | 2 Birch Hill Lane, Dallas, PA 18612 | 2008-02-01 |
| 1063621233 | Back Mountain Pediatrics | Clinical Medical Laboratory | 550 Memorial Highway, Dallas, PA 18612 | 2007-05-22 |
| 1760699177 | Leonard M Evans | Internal Medicine | 1806 Country Club Apartments, Dallas, PA 18612 | 2007-05-16 |
| 1417170549 | Clem-mar House, Inc. | Substance Abuse Rehabilitation Facility | 2860 State Route 309, Dallas, PA 18612 | 2007-04-10 |
| Find all providers in zip 18612 | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982214375 | Hippomed Wellness Clinics Limited Company | Clinic/Center | 5930 Lbj Fwy Ste 380, Dallas, TX 75240-6370 | 2020-07-31 |
| 1417566415 | Bonnieview-overton Medical Clinic | Clinic/Center | 3507 Bonnie View Rd, Dallas, TX 75216-4704 | 2020-07-26 |
| 1679123632 | Equilyst LLC. | Clinic/Center | 2909 Canton St Ste C, Dallas, TX 75226-3508 | 2019-09-12 |
| 1962977355 | Resolves Healthcare Services, LLC | Clinic/Center | 5151 Belt Line Rd Ste 715, Dallas, TX 75254-7547 | 2018-10-11 |
| 1376067793 | William Parker Highland Park | Clinic/Center | 4442 Lovers Lane, Dallas, TX 75225-6923 | 2017-07-27 |
| 1851724918 | Joey D. Tran, Od Pllc | Clinic/Center | 5334 Ross Ave Ste 100, Dallas, TX 75206-7402 | 2013-08-13 |
| 1972856631 | Bridge Medical Group LLC | Clinic/Center | 4303 N Central Expy, Dallas, TX 75205-5597 | 2012-10-18 |
| 1609127000 | Lyndsay M Posey | Clinic/Center | 289 E Ellendale Ave Ste 601, Dallas, OR 97338-1570 | 2012-09-25 |
| 1780969584 | Questcare | Clinic/Center | 12221 Merit Dr Ste 1620, Dallas, TX 75251-2208 | 2011-10-13 |
| 1265664874 | Glamour Technology and Wellness | Clinic/Center | 206 S Zang Blvd, Dallas, TX 75208-4519 | 2009-08-14 |
| Find all providers in DALLAS | ||||
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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.