| 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 |
|---|---|
| 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 |
|---|---|
| Provider Enumeration Date | 11/07/2005 |
| Last Update Date | 01/17/2008 |
| Medicare PECOS PAC ID | 7214837202 |
|---|---|
| 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 |
|---|---|
| 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 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 | 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 |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1467650135 PECOS PAC ID: 8426201815 Enrollment ID: I20160219000419 |
| Provider Name | John 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 | 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 | 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 | Robert W Phares |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083666598 PECOS PAC ID: 1254323058 Enrollment ID: I20200411000758 |
| 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 | 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 Mamaril |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497246342 PECOS PAC ID: 7719232479 Enrollment ID: I20211019000481 |
| Provider Name | Jonette M Mcclelland |
|---|---|
| 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 | Sarah A Loveland Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194499376 PECOS PAC ID: 7416305362 Enrollment ID: I20231203000087 |
| Provider Name | Angela Kalia |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1952922882 PECOS PAC ID: 1052731437 Enrollment ID: I20231213003413 |
| Provider Name | Varun Dobariya |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1093336802 PECOS PAC ID: 6406271089 Enrollment ID: I20240208003082 |
| Provider Name | Narayan Subedi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366217077 PECOS PAC ID: 3274979075 Enrollment ID: I20240315000715 |
| Provider Name | Kimberly Ann Hvozdik |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922845395 PECOS PAC ID: 2365981990 Enrollment ID: I20240828000293 |
| Provider Name | Bryce J Kesling |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336950534 PECOS PAC ID: 3173044716 Enrollment ID: I20250311003156 |
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 |