NPI |
1083740021 |
The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number. |
Entity Type Code |
2 |
Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual
human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO). |
Employer Identification Number EIN |
|
The Employer Identification Number (EIN), assigned by the IRS, of the provider being identified. |
Provider Organization Name Legal Business Name |
OCCUPATIONAL HEALTH CENTERS OF THE SOUTHWEST PA |
The name of the organization provider. If the provider is an organization, this is the legal business name. |
Provider Other Organization Name |
CONCENTRA MEDICAL CENTER |
Other name by which the organization provider is or has been known. |
Provider Other Organization Name Type Code |
3 |
The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number. |
Provider First Line Business Practice Location Address |
2100 DIXON ST |
Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual
human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO). |
Provider Second Line Business Practice Location Address |
SUITE E |
The last name of the provider. If the provider is an individual, this is the legal name. |
Provider Business Practice Location Address City Name |
DES MOINES |
The city name in the location address of the provider being identified. |
Provider Business Practice Location Address State Name |
IA |
The State code in the location of the provider
being identified. |
Provider Business Practice Location Address Postal Code |
503162174 |
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. |
Provider Business Practice Location Address Country Code If outside U S |
US |
The country code in the location address of the provider being identified. |
Provider Business Practice Location Address Telephone Number |
5152651020 |
The telephone number associated with the location address of the provider being identified. |
Provider Business Practice Location Address Fax Number |
5152651511 |
The fax number associated with the location
address of the provider being identified. |
Provider Enumeration Date |
2/26/2007 |
The date the provider was assigned a unique identifier (assigned an NPI). |
Last Update Date |
6/29/2016 |
The date that a record was last updated or changed. |
Authorized Official Last Name |
HASSETT |
The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider. |
Authorized Official First Name |
ROBERT |
The first name of the authorized official. |
Authorized Official Middle Name |
G |
The middle name of the authorized official. |
Authorized Official Title or Position |
PRESIDENT / TREASURER |
The title or position of the authorized official. |
Authorized Official Telephone Number |
9723648000 |
The 10-position telephone number of the authorized official. |
Healthcare Provider Taxonomy Code 1 |
261QP2000X |
The date that a record was last updated or changed. |
Healthcare Provider Primary Taxonomy Switch 1 |
N |
|
Healthcare Provider Taxonomy Code 2 |
261QX0100X |
|
Healthcare Provider Primary Taxonomy Switch 2 |
N |
|
Healthcare Provider Taxonomy Code 3 |
261QH0100X |
|
Healthcare Provider Primary Taxonomy Switch 3 |
Y |
|
Is Organization Subpart |
N |
|
Authorized Official Name Prefix Text |
DR. |
|
Authorized Official Credential Text |
DO MPH |
|