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BACK MOUNTAIN PEDIATRICS
NPI 1063621233
Pediatrics in Dallas, PA

Active since May 22, 2007
550 MEMORIAL HIGHWAY, DALLAS, PA 18612(570) 675-7955(570) 675-7882 Get Directions Write a Review

NPPES record last updated: September 11, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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

About Back Mountain Pediatrics NPPES

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

BACK MOUNTAIN PEDIATRICS (NPI 1063621233) is a healthcare organization registered as a pediatrics in Dallas, Pennsylvania and active in the NPI registry since May 2007. The organization lists Joan E Greulick, Owner, as its authorized official.

NPPES Registry Identity

NPI1063621233
Entity TypeOrganization
Primary Taxonomy208000000X
Legal Business NameBACK MOUNTAIN PEDIATRICS
Location Address550 MEMORIAL HIGHWAYDallas, PA 18612
Mailing Address550 Memorial Highway, Suite 1Dallas, PA 18612 · (570) 675-7955 · Fax (570) 675-7882
Phone(570) 675-7955
Fax(570) 675-7882
Organization SubpartNo
Authorized OfficialJoan E GreulickOwner · (570) 675-7955
Enumeration DateMay 22, 2007
Last NPPES UpdateSeptember 11, 20252 updates tracked since enumeration
✔ NPI 1063621233 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in PA · MD024845E
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
Also ListedClinical Medical LaboratoryTaxonomy 291U00000X · License 022874 (PA)
550 MEMORIAL HIGHWAY, Dallas, PA 18612
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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 Back Mountain Pediatrics's NPI number?

The NPI number for Back Mountain Pediatrics is 1063621233. It was assigned to this organization in the NPPES registry on May 22, 2007.

Where is Back Mountain Pediatrics located?

Back Mountain Pediatrics is located at 550 Memorial Highway, Dallas, PA 18612. The listed phone number is (570) 675-7955.

What is Back Mountain Pediatrics's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

When was this NPI record last updated?

The NPPES record for Back Mountain Pediatrics 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 11 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.