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CENTERVILLE CLINICS, INC
NPI 1053392852
Physician Assistant - Medical in California, PA

Active since November 09, 2005CLIA 39D0906393 · Waiver
1152 WOOD ST, CALIFORNIA, PA 15419(724) 938-2122 Get Directions Write a Review

NPPES record last updated: September 11, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Sep 11, 2025, Aug 22, 2020 (2 updates tracked since 2020).

About Centerville Clinics, Inc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CENTERVILLE CLINICS, INC (NPI 1053392852) is a healthcare organization registered as a medical in California, Pennsylvania and active in the NPI registry since November 2005. The organization holds a CLIA Waiver certificate valid through October 4, 2026 and lists Patricia Martos, Director Personnel Finance, as its authorized official.

NPPES Registry Identity

NPI1053392852
Entity TypeOrganization
Primary Taxonomy363AM0700X
Legal Business NameCENTERVILLE CLINICS, INC
Location Address1152 WOOD STCalifornia, PA 15419-1260
Mailing Address1070 Old National PikeFredericktown, PA 15333-2114 · (724) 632-6801 · Fax (724) 632-6312
Phone(724) 938-2122
Organization SubpartNo
Authorized OfficialPatricia MartosDirector Personnel Finance · (724) 632-6801
Enumeration DateNovember 9, 2005
Last NPPES UpdateSeptember 11, 20252 updates tracked since enumeration
✔ NPI 1053392852 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AM0700X
Also ListedFamily MedicineTaxonomy 207Q00000X
Also ListedInternal MedicineTaxonomy 207R00000X
1152 WOOD ST, California, PA 15419
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Other Identifiers 1

Medicaid1007288440029PA

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 39D0906393

Centerville Clinics Inc - California · California, PA
Active · expires Oct 4, 2026
CLIA Number39D0906393
Laboratory TypePhysician Office
Certificate Effective DateOctober 5, 2024
Certificate Expiration DateOctober 4, 2026
Laboratory DirectorDr. Charles Brown
Laboratory Phone(724) 938-2122
Laboratory LocationCenterville Clinics Inc - California1152 Wood Street, California, PA 15419
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CENTERVILLE CLINICS, INC.
Case Manager/Care Coordinator
1152 WOOD ST
CALIFORNIA, PA 15419
Washington County (724) 938-2099
MR. MATTHEW P ANDERSON
Case Manager/Care Coordinator
1152 WOOD ST
CALIFORNIA, PA 15419
Washington County (724) 938-2099
MRS. BREAN RAE EWART ELLSWORTH B.A.
Case Manager/Care Coordinator
1152 WOOD ST
CALIFORNIA, PA 15419
Washington County (724) 938-2099
MEGAN KATHERINE RABATIN B,A.
Case Manager/Care Coordinator
1152 WOOD ST
CALIFORNIA, PA 15419
Washington County (724) 938-2099
MR. JOSEPH NICK HORVATH B.A.
Case Manager/Care Coordinator
1152 WOOD ST
CALIFORNIA, PA 15419
Washington County (724) 938-2099
MR. BRADLEY JAMES NUCKELS
Case Manager/Care Coordinator
1152 WOOD ST
CALIFORNIA, PA 15419
Washington County (724) 938-2099
MRS. JEANNE MARIE HOLZAPFEL BSW
Case Manager/Care Coordinator
1152 WOOD ST
CALIFORNIA, PA 15419
Washington County (724) 938-2099
MR. JEFFREY L MORRIS
Case Manager/Care Coordinator
1152 WOOD ST
CALIFORNIA, PA 15419
Washington County (724) 938-2099

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Centerville Clinics, Inc's NPI number?

The NPI number for Centerville Clinics, Inc is 1053392852. It was assigned to this organization in the NPPES registry on November 9, 2005.

Where is Centerville Clinics, Inc located?

Centerville Clinics, Inc is located at 1152 Wood St, California, PA 15419. The listed phone number is (724) 938-2122.

What is Centerville Clinics, Inc's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Does Centerville Clinics, Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 39D0906393) is associated with this NPI, valid through October 4, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Centerville Clinics, Inc was last updated on September 11, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.