KEYSTONE RURAL HEALTH CONSORTIA, INC. (NPI# 1780776427) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780776427 |
| Entity Type | Organization |
| Organization Name | KEYSTONE RURAL HEALTH CONSORTIA, INC. |
| Other Organization Name | CENTRAL POTTER HEALTH CENTER |
| Practice Address |
71 Elk St Coudersport PA 16915-9601 |
| Practice Telephone | 8142747070 |
| Practice Fax Number | 8142747879 |
| Mailing Telephone | 8142747070 |
| Mailing Fax Number | 8142747879 |
| Enumeration Date | 2006-09-29 |
| Last Update Date | 2008-01-29 |
| Authorized Official Name | MR. ANTHONY C. MOSCATO (ADMINISTRATOR) |
| Authorized Official Telephone | 8144861115 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Central Potter Health Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881146884 | Keystone Rural Health Consortia, Inc. | Clinic/Center | 176 Skyline Dr., Kersey, PA 15846 | 2016-10-26 |
| 1053784942 | Keystone Rural Health Consortia, Inc. | Clinic/Center | 172 Skyline Drive, Kersey, PA 15846 | 2015-11-02 |
| 1801988670 | Keystone Rural Health Consortia, Inc. | Clinic/Center | 17129 Route 6, Smethport, PA 16749-4027 | 2006-09-29 |
| 1699867325 | Keystone Rural Health Consortia, Inc. | Clinic/Center | 90 E 2nd St, Emporium, PA 15834-1302 | 2006-09-29 |
| 1609968114 | Keystone Rural Health Consortia, Inc. | Clinic/Center | 90 E 2nd St, Emporium, PA 15834-1302 | 2006-09-29 |
| Street Address |
71 ELK ST |
| City | COUDERSPORT |
| State | PA |
| Zip Code | 16915-9601 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740249085 | Christian O Mcmonigal Jr. | Physician Assistant | 71 Elk St, Coudersport, PA 16915-9601 | 2006-03-23 |
| 1619204641 | Charles Cole Memorial Hospital | Clinic/Center | 71 Elk St, Coudersport, PA 16915-9601 | 2009-11-12 |
| 1033283437 | Charles Cole Memorial Hospital | Clinic/Center | 71 Elk St, Coudersport, PA 16915-9601 | 2006-11-17 |
| 1275634909 | Crystal L Fowler | Physician Assistant | 71 Elk St, Coudersport, PA 16915-9601 | 2006-09-26 |
| 1992741375 | Jeffrey Scott Nolt | Family Medicine | 71 Elk St, Coudersport, PA 16915-9601 | 2006-06-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134396930 | Carla J Muirhead | Registered Nurse | 1001 East 2nd Street, Coudersport, PA 16915 | 2008-05-12 |
| 1396926374 | Jeremy T Reed | Otolaryngology | 1001 E 2nd St Ste C, Coudersport, PA 16915 | 2007-11-19 |
| 1437274768 | Lynn Meredith Cornish | Dentist | 303 E Maple Street, Coudersport, PA 16915 | 2007-03-19 |
| 1508911736 | William T Kelley | Emergency Medicine | 1000 East 2nd Street, Coudersport, PA 16915 | 2007-01-25 |
| 1568569168 | Peter C Ryan | Dentist | 438 East Second St, Coudersport, PA 16915 | 2006-09-19 |
| 1538193248 | Eagle Emergency Physicians LLC | Emergency Medicine | 1000 E Second St, Emergency Department, Coudersport, PA 16915 | 2006-07-10 |
| 1245294875 | Victor Douglas Brown | Dentist | 6 Niles Hill Road, Coudersport, PA 16915 | 2006-04-12 |
| 1316312234 | Cody William Greene | Physical Therapist | 1028 E. Second Street, Coudersport, PA 16915 | 2015-12-03 |
| 1770958696 | Rosanne Marie Pesock | Occupational Therapy Assistant | 1028 E. Second Street, Coudersport, PA 16915 | 2015-12-03 |
| 1043685977 | Trisha Marie Bauer | Occupational Therapy Assistant | 1028 E. Second Street, Coudersport, PA 16915 | 2015-12-03 |
| Find all providers in zip 16915 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
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| Find all providers with the same taxonomy | ||||
| City | COUDERSPORT |
| Zip Code | 16915 |
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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.