UPMC WILLIAMSPORT (NPI# 1285719559) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285719559 |
| Entity Type | Organization |
| Organization Name | UPMC WILLIAMSPORT |
| Practice Address |
700 High Street Williamsport PA 17701-3198 |
| Mailing Address |
600 Grant Street, Us Steel Tower, 59th Floor C/o Renee Johnson Pittsburgh PA 15219-2740 |
| Practice Telephone | 5703211000 |
| Practice Fax Number | 5703213199 |
| Mailing Telephone | 4126236303 |
| Enumeration Date | 2006-10-26 |
| Last Update Date | 2020-02-26 |
| Authorized Official Name | MR. CHRISTOPHER STOCKHAUSEN (CFO) |
| Authorized Official Telephone | 4125789592 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QA1903X |
Clinic/Center Specialization: Ambulatory Surgical |
234601 | PA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | 1007548350014 | 05 | |
| PA | BLUE CROSS PIN | 390045 | 01 |
| PA | HEALTH AMERICA PIN | 390045 | 01 |
| PA | AMERIHEALTH ADMINSTR PIN | 000109 | 01 |
| PA | AETNA PIN | 390045 | 01 |
| PA | BLACK LUNG PROGRAM PIN | 301400 | 01 |
| PA | GEISINGER HEALTH PLAN PIN | 29796 | 01 |
| PA | FIRST PRIORITY HEALTH PIN | 074006 | 01 |
| PA | KEYSTONE MERCY HEALTH PIN | 1017347 | 01 |
| PA | HEALTH ASSURANCE PIN | 390045 | 01 |
| PA | AMERIHEALTH HMO AMER PIN | 20007166 | 01 |
| Other Name | Type Code |
|---|---|
| Williamsport Regional Medical Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 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 |
| 1063597334 | Upmc Williamsport | Clinic/Center | 777 Rural Ave, Williamsport, PA 17701-3109 | 2006-10-26 |
| 1093890360 | Upmc Williamsport | Ambulance | 777 Rural Ave, Williamsport, PA 17701-3109 | 2006-10-26 |
| 1740365097 | Upmc Williamsport | Clinic/Center | 700 High St, Williamsport, PA 17701-3198 | 2006-10-26 |
| 1982788048 | Upmc Williamsport | Clinic/Center | 740 High St, Williamsport, PA 17701-3102 | 2006-10-25 |
| 1609801976 | Upmc Williamsport | Ambulance | 700 High St, Williamsport, PA 17701-3198 | 2006-07-12 |
| 1588698922 | Upmc Williamsport | Rehabilitation Unit | 700 High St, Williamsport, PA 17701-3198 | 2006-07-10 |
| 1710930557 | Upmc Williamsport | Nurse Anesthetist, Certified Registered | 700 High St, Williamsport, PA 17701-3198 | 2006-05-19 |
| Street Address |
700 HIGH STREET |
| City | WILLIAMSPORT |
| State | PA |
| Zip Code | 17701-3198 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083677868 | Susquehanna Physician Services | Internal Medicine | 700 High Street, Williamsport, PA 17701-3198 | 2006-04-11 |
| 1679127211 | Jessica Lyn Percoco | Registered Nurse | 700 High Street, Williamsport, PA 17701 | 2019-08-01 |
| 1619440971 | Debra Kay Canellos | Nurse Practitioner | 700 High Street, Williamsport, PA 17701-3198 | 2019-01-09 |
| 1013351378 | Timothy Edward Wirth | Pharmacist | 700 High Street, Pharmacy Department, Williamsport, PA 17701 | 2013-04-17 |
| 1760730824 | Alana E John | Internal Medicine | 700 High Street, Williamsport, PA 17701-3198 | 2012-08-21 |
| 1639432628 | Ashley Nichole Pence | Pediatrics | 700 High Street, Williamsport, PA 17701-3198 | 2012-06-25 |
| 1912266685 | Brent M Carpenter | Nurse Anesthetist, Certified Registered | 700 High Street, Williamsport, PA 17701-3198 | 2012-05-15 |
| 1235366857 | Susquehanna Physician Services | Physician Assistant | 700 High Street, Williamsport, PA 17701-3198 | 2009-06-22 |
| 1518113570 | Marissa Lara Ambron | Internal Medicine | 700 High Street, Williamsport, PA 17701-3198 | 2008-08-11 |
| 1497962286 | Puneet Gupta | Internal Medicine | 700 High Street, Williamsport, PA 17701-3198 | 2007-05-17 |
| 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 |
| 1285718312 | Divine Providence Hospital of The Sisters of Christian Charity | Clinic/Center | 1100 Grampian Blvd, Williamsport, PA 17701-1909 | 2006-10-25 |
| 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 |
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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.