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CHESTNUT RIDGE FAMILY MEDICINE - UPMC
NPI 1104081785
Non-Pharmacy Dispensing Site in Fishertown, PA

Active since July 23, 2008CLIA 39D0180528 · Waiver
2040 QUAKER VALLEY RD, FISHERTOWN, PA 15539(814) 839-4152 Get Directions Write a Review

NPPES record last updated: May 7, 2013. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Chestnut Ridge Family Medicine - Upmc NPPES

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

CHESTNUT RIDGE FAMILY MEDICINE - UPMC (NPI 1104081785) is a healthcare organization registered as a non-pharmacy dispensing site in Fishertown, Pennsylvania and active in the NPI registry since July 2008. The organization holds a CLIA Waiver certificate valid through April 24, 2028 and lists Kenny Heine, Vp Of Operations, as its authorized official.

NPPES Registry Identity

NPI1104081785
Entity TypeOrganization
Primary Taxonomy332900000X
Legal Business NameUPMC COMMUNITY MEDICINE, INC.
Location Address2040 QUAKER VALLEY RDFishertown, PA 15539-9723
Mailing Address5626 Oberlin Dr, Suite 110San Diego, CA 92121-1705
Phone(814) 839-4152
Organization SubpartYesParent: Medvantx, Inc.
Authorized OfficialKenny HeineVp Of Operations · (858) 625-2990
Enumeration DateJuly 23, 2008
Last NPPES UpdateMay 7, 2013
✔ NPI 1104081785 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNon-Pharmacy Dispensing SiteSuppliers
Taxonomy Code332900000X
License✔ Licensed in PA · OS010738L
Definition

A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.)

2040 QUAKER VALLEY RD, Fishertown, PA 15539
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Other Names 1

Doing Business AsChestnut Ridge Family Medicine - Upmc

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Sanford Health Plan.Insurance ›

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 39D0180528

Chestnut Ridge Family Med Upmc · Fishertown, PA
Active · expires Apr 24, 2028
CLIA Number39D0180528
Laboratory TypePhysician Office
Certificate Effective DateApril 25, 2026
Certificate Expiration DateApril 24, 2028
Laboratory DirectorDr. Beth A. Clark
Laboratory Phone(814) 839-4152
Laboratory LocationChestnut Ridge Family Med Upmc2040 Quaker Valley Road, Fishertown, PA 15539
CLIA data matches this NPI record on: Address Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

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

DR. BETH A CLARK DO
Specialist
2040 QUAKER VALLEY RD
FISHERTOWN, PA 15539
Bedford County (814) 839-4152

Frequently Asked Questions

What is UPMC COMMUNITY MEDICINE, INC.'s NPI number?

The NPI number assigned to this healthcare provider is 1104081785, enumerated as an "organization" on July 23, 2008.

Where is the provider located?

The provider is located at 2040 QUAKER VALLEY RD FISHERTOWN, PA 15539 and the phone number is (814) 839-4152.

What is the provider's specialty?

Non-Pharmacy Dispensing Site with taxonomy code 332900000X.

What insurance does UPMC COMMUNITY MEDICINE, INC. accept?

The provider might be accepting Accepts: Sanford Health Plan. Please consult your insurance carrier or call the provider to verify.