Centerville Clinics, Inc. | |
1070 Old National Pike Fredericktown PA 15333-2114 | |
(724) 632-6801 | |
(724) 632-6312 |
Full Name | Centerville Clinics, Inc. |
---|---|
Speciality | Family Medicine |
Location | 1070 Old National Pike, Fredericktown, Pennsylvania |
Authorized Official Name and Position | Patricia Martos (DIRECTOR PERSONNEL/FINANCE) |
Authorized Official Contact | 7246326801 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Centerville Clinics, Inc. 1070 Old National Pike Fredericktown PA 15333-2114 Ph: (724) 632-6801 | Centerville Clinics, Inc. 1070 Old National Pike Fredericktown PA 15333-2114 Ph: (724) 632-6801 |
NPI Number | 1801877048 |
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Provider Enumeration Date | 11/07/2005 |
Last Update Date | 01/17/2008 |
Medicare PECOS PAC ID | 7214837202 |
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Medicare Enrollment ID | O20040427000681 |
Identifier | Type | State | Issuer |
---|---|---|---|
1801877048 | NPI | - | NPPES |
1007288440027 | Medicaid | PA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | Christopher C Allen |
---|---|
Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
Provider Identifiers | NPI Number: 1548242449 PECOS PAC ID: 8527971134 Enrollment ID: I20031110000631 |
Provider Name | Marty Cole |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1295846681 PECOS PAC ID: 8224934765 Enrollment ID: I20031208000469 |
Provider Name | John F Pensock |
---|---|
Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
Provider Identifiers | NPI Number: 1396729638 PECOS PAC ID: 2163317256 Enrollment ID: I20040218000157 |
Provider Name | Bryan C Donohue |
---|---|
Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
Provider Identifiers | NPI Number: 1952383846 PECOS PAC ID: 3274446869 Enrollment ID: I20040218000188 |
Provider Name | Laila R Avetta |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1457424426 PECOS PAC ID: 8921095274 Enrollment ID: I20040428000845 |
Provider Name | Kishor E Joshi |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1518970516 PECOS PAC ID: 8123923976 Enrollment ID: I20040511000563 |
Provider Name | Sean M Conley |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1518957802 PECOS PAC ID: 1557348430 Enrollment ID: I20040630000248 |
Provider Name | Vasilios Spyropoulos |
---|---|
Provider Type | Practitioner - Podiatry |
Provider Identifiers | NPI Number: 1659396315 PECOS PAC ID: 9234110206 Enrollment ID: I20040820000538 |
Provider Name | Kevin Alan Zacour |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1245206853 PECOS PAC ID: 1850368911 Enrollment ID: I20040916000882 |
Provider Name | Marvin Mcgowan |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1851382535 PECOS PAC ID: 2264485689 Enrollment ID: I20050225000407 |
Provider Name | Charles Richard Brown |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1821176470 PECOS PAC ID: 2668419755 Enrollment ID: I20050411000643 |
Provider Name | Theresa Jean Lacava |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1063412088 PECOS PAC ID: 5799724670 Enrollment ID: I20050429000454 |
Provider Name | Carla Sterbutzel Franks |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1144429002 PECOS PAC ID: 6103830534 Enrollment ID: I20060208000353 |
Provider Name | Daniel L Holt |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1922003375 PECOS PAC ID: 1456354430 Enrollment ID: I20060811000138 |
Provider Name | Charlene R Saloom |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1558387472 PECOS PAC ID: 8628072113 Enrollment ID: I20061016000004 |
Provider Name | Alvaro N Changco |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1922009240 PECOS PAC ID: 3779689617 Enrollment ID: I20070509000396 |
Provider Name | Natalee A Kontir |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1770779761 PECOS PAC ID: 1052492030 Enrollment ID: I20080116000115 |
Provider Name | Robert L Belluso |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1912192568 PECOS PAC ID: 0648345033 Enrollment ID: I20080820000017 |
Provider Name | Julie K Derosa |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1285682856 PECOS PAC ID: 1456426840 Enrollment ID: I20080820000033 |
Provider Name | Jennifer Muhly |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1750375168 PECOS PAC ID: 3072518968 Enrollment ID: I20080820000664 |
Provider Name | Brandi B Kalich |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1689826174 PECOS PAC ID: 8426103615 Enrollment ID: I20090911000681 |
Provider Name | Dimitri M Petro |
---|---|
Provider Type | Practitioner - General Practice |
Provider Identifiers | NPI Number: 1760469456 PECOS PAC ID: 7012044282 Enrollment ID: I20100420000325 |
Provider Name | Anita C Fiala |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1720079296 PECOS PAC ID: 9133256357 Enrollment ID: I20100420000799 |
Provider Name | Charles M Irvin |
---|---|
Provider Type | Practitioner - Podiatry |
Provider Identifiers | NPI Number: 1457337032 PECOS PAC ID: 3072641356 Enrollment ID: I20100506000531 |
Provider Name | Edward J Salopek |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1457341745 PECOS PAC ID: 7517096241 Enrollment ID: I20100518000851 |
Provider Name | Jer Tsai |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1477543817 PECOS PAC ID: 5890824270 Enrollment ID: I20100524000134 |
Provider Name | Robert S English |
---|---|
Provider Type | Practitioner - Dermatology |
Provider Identifiers | NPI Number: 1447237680 PECOS PAC ID: 5890987416 Enrollment ID: I20101014000044 |
Provider Name | Aaron G Lenhart |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1710161336 PECOS PAC ID: 7416142534 Enrollment ID: I20101115000186 |
Provider Name | Ashok K Sahai |
---|---|
Provider Type | Practitioner - General Surgery |
Provider Identifiers | NPI Number: 1609838549 PECOS PAC ID: 7214118298 Enrollment ID: I20110223001191 |
Provider Name | Lawrence Callahan |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1669511259 PECOS PAC ID: 7911182837 Enrollment ID: I20110419000568 |
Provider Name | Prafullchandra D Vora |
---|---|
Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
Provider Identifiers | NPI Number: 1447256342 PECOS PAC ID: 8921271206 Enrollment ID: I20111102000053 |
Provider Name | Shweta Arora |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1841447000 PECOS PAC ID: 7315111234 Enrollment ID: I20111110000603 |
Provider Name | Brigitte L Sapko |
---|---|
Provider Type | Practitioner - Podiatry |
Provider Identifiers | NPI Number: 1134154743 PECOS PAC ID: 8921274663 Enrollment ID: I20111230000591 |
Provider Name | Josefina D Paderes |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1619106697 PECOS PAC ID: 8527212992 Enrollment ID: I20130212000377 |
Provider Name | Mary A Zakutney |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1720055049 PECOS PAC ID: 1153473251 Enrollment ID: I20130219000212 |
Provider Name | Brian A Staub |
---|---|
Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
Provider Identifiers | NPI Number: 1033358734 PECOS PAC ID: 5890936280 Enrollment ID: I20130727000151 |
Provider Name | Maria Isabel B Gauna |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1831417427 PECOS PAC ID: 8527284397 Enrollment ID: I20140731000905 |
Provider Name | Apryl M Shiffler |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1295140010 PECOS PAC ID: 0042432809 Enrollment ID: I20141111000496 |
Provider Name | Irina Pritchard |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1144619909 PECOS PAC ID: 5294054821 Enrollment ID: I20150504001814 |
Provider Name | Erika R Robaugh |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1437525987 PECOS PAC ID: 2163739459 Enrollment ID: I20150918001768 |
Provider Name | Michelle Marie Cohen |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1124497995 PECOS PAC ID: 6103126453 Enrollment ID: I20151118002232 |
Provider Name | Nima J Tirgan |
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Provider Type | Practitioner - Ophthalmology |
Provider Identifiers | NPI Number: 1467650135 PECOS PAC ID: 8426201815 Enrollment ID: I20160219000419 |
Provider Name | John R Beabout |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1225429129 PECOS PAC ID: 4486951852 Enrollment ID: I20160330000602 |
Provider Name | Tara Spain Lemaire |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1093710170 PECOS PAC ID: 2961395678 Enrollment ID: I20160614001673 |
Provider Name | Fred M Powell |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1730637794 PECOS PAC ID: 2264714914 Enrollment ID: I20170113000206 |
Provider Name | Katherine D Gialames |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1093250797 PECOS PAC ID: 7719261460 Enrollment ID: I20170524000082 |
Provider Name | Cortney R Smith |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1861935058 PECOS PAC ID: 7517244817 Enrollment ID: I20170530000965 |
Provider Name | Jessica Brooks |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1952825663 PECOS PAC ID: 9335405000 Enrollment ID: I20171113002971 |
Provider Name | Danielle M Guerrieri |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1053839282 PECOS PAC ID: 7012273600 Enrollment ID: I20171115001035 |
Provider Name | Bethany Wagner |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1831614999 PECOS PAC ID: 5395001804 Enrollment ID: I20171115002567 |
Provider Name | Joseph Francis Tavares |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1790850097 PECOS PAC ID: 6204938079 Enrollment ID: I20180125001857 |
Provider Name | Tina R Pierce |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1588198139 PECOS PAC ID: 6305107178 Enrollment ID: I20180220000314 |
Provider Name | Jill M Miscovich |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1114433729 PECOS PAC ID: 4981965316 Enrollment ID: I20180228001408 |
Provider Name | Nicole R Jackowski |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1528576618 PECOS PAC ID: 5890058853 Enrollment ID: I20180405000134 |
Provider Name | Katina Fetsko |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1649622135 PECOS PAC ID: 2668736919 Enrollment ID: I20180514001565 |
Provider Name | Kyle Patrick Duff |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1689052920 PECOS PAC ID: 6800190141 Enrollment ID: I20180822002445 |
Provider Name | Gary G Butler |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1417434358 PECOS PAC ID: 6901156520 Enrollment ID: I20180831001664 |
Provider Name | Alexandria Bakos |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1003397365 PECOS PAC ID: 9931450947 Enrollment ID: I20181001001454 |
Provider Name | Coreyann Fluker |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1467965236 PECOS PAC ID: 4880946862 Enrollment ID: I20181003001419 |
Provider Name | Nishant Ashok Gandhi |
---|---|
Provider Type | Practitioner - Anesthesiology |
Provider Identifiers | NPI Number: 1477734986 PECOS PAC ID: 1355506163 Enrollment ID: I20181205000131 |
Provider Name | Justin Trunzo |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1417424276 PECOS PAC ID: 7416294657 Enrollment ID: I20190128000146 |
Provider Name | Jonathan William Decker |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1619275781 PECOS PAC ID: 1557686334 Enrollment ID: I20190211000232 |
Provider Name | Amber M Prebeg |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1891251625 PECOS PAC ID: 3072556091 Enrollment ID: I20190405001105 |
Provider Name | Tina Keener |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1164990958 PECOS PAC ID: 2961745203 Enrollment ID: I20190530000281 |
Provider Name | Daniel Ryan Hinderliter |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1912543422 PECOS PAC ID: 5395172225 Enrollment ID: I20200305000882 |
Provider Name | Amy Goodwin |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1326686882 PECOS PAC ID: 2264853860 Enrollment ID: I20200608001956 |
Provider Name | Mary A Hodgson |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1851912091 PECOS PAC ID: 5294152856 Enrollment ID: I20200827000657 |
Provider Name | Danielle M Zachar |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1639602832 PECOS PAC ID: 4385900265 Enrollment ID: I20200904000093 |
Provider Name | Christina M Lombard |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1689286999 PECOS PAC ID: 0547689747 Enrollment ID: I20201007000581 |
Provider Name | Crystal L Andrews |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1255947800 PECOS PAC ID: 8820409659 Enrollment ID: I20201130000471 |
Provider Name | Amanda G Coltura |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1902436132 PECOS PAC ID: 4082025788 Enrollment ID: I20201202001047 |
Provider Name | Robbie M Popelas |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1871188656 PECOS PAC ID: 2567871015 Enrollment ID: I20210512003161 |
Provider Name | Amanda Hoover |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1992322697 PECOS PAC ID: 8729489729 Enrollment ID: I20210629000407 |
Provider Name | Susan E Albert |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1982287017 PECOS PAC ID: 4587066790 Enrollment ID: I20210712000355 |
Provider Name | Bradley Milam |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1942706668 PECOS PAC ID: 0244577716 Enrollment ID: I20210805003665 |
Provider Name | Rebecca Kunkle |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1255910436 PECOS PAC ID: 9032515911 Enrollment ID: I20210831003273 |
Provider Name | Al L Mamaril |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1497246342 PECOS PAC ID: 7719232479 Enrollment ID: I20211019000481 |
Provider Name | Jonette M Mcclelland |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1912257551 PECOS PAC ID: 4688062938 Enrollment ID: I20211019002808 |
Provider Name | Joshua James Basilone |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1255089124 PECOS PAC ID: 3375939853 Enrollment ID: I20220409000229 |
Provider Name | Maria R Bening |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1194384800 PECOS PAC ID: 5193106938 Enrollment ID: I20220725003115 |
Provider Name | Thomas G Wittman |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1821651647 PECOS PAC ID: 6608259171 Enrollment ID: I20220816001615 |
Provider Name | Ali Mahdi |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1952887291 PECOS PAC ID: 8022491273 Enrollment ID: I20220820000114 |
Provider Name | Derek Bowman |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1942921663 PECOS PAC ID: 6406226562 Enrollment ID: I20230105002507 |
Provider Name | Mary Capella |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1275249005 PECOS PAC ID: 6800244583 Enrollment ID: I20231120001895 |
Provider Name | Melissa A Turek |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1144903634 PECOS PAC ID: 9931557519 Enrollment ID: I20231120002180 |
Provider Name | Angela Kalia |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1952922882 PECOS PAC ID: 1052731437 Enrollment ID: I20231213003413 |
Provider Name | Destiny Ray |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1790550820 PECOS PAC ID: 6507209731 Enrollment ID: I20240205003309 |
Provider Name | Narayan Subedi |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1366217077 PECOS PAC ID: 3274979075 Enrollment ID: I20240315000715 |
Centerville Clinics, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1070 Old National Pike, Fredericktown, PA 15333 Phone: 724-632-6801 Fax: 724-632-6312 | |
Centerville Clinics, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1070 Old National Pike, Fredericktown, PA 15333 Phone: 724-632-6801 Fax: 724-632-6312 |