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MEADVILLE UROLOGY
NPI 1841782869
Urology in Meadville, PA

Active since June 05, 2018CLIA 39D2009809 · Waiver
765 LIBERTY ST STE 207A, MEADVILLE, PA 16335(814) 373-2156(814) 373-2159 Get Directions Write a Review

NPPES record last updated: August 8, 2018. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Meadville Urology NPPES

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

MEADVILLE UROLOGY (NPI 1841782869) is a healthcare organization registered as an urology in Meadville, Pennsylvania and active in the NPI registry since June 2018. The organization holds a CLIA Waiver certificate valid through March 5, 2027 and lists Cory Frank Jackson, Controller, as its authorized official.

NPPES Registry Identity

NPI1841782869
Entity TypeOrganization
Primary Taxonomy208800000X
Legal Business NameMEADVILLE MEDICAL CENTER
Location Address765 LIBERTY ST STE 207AMeadville, PA 16335
Mailing Address1034 Grove StMeadville, PA 16335-2945 · (814) 373-3434 · Fax (814) 373-2159
Phone(814) 373-2156
Fax(814) 373-2159
Organization SubpartNo
Authorized OfficialCory Frank JacksonController · (814) 333-5766
Enumeration DateJune 5, 2018
Last NPPES UpdateAugust 8, 2018
✔ NPI 1841782869 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyUrologyAllopathic & Osteopathic Physicians
Taxonomy Code208800000X
Definition

A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures.

765 LIBERTY ST STE 207A, Meadville, PA 16335
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Other Names 1

Doing Business AsMeadville Urology

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 39D2009809

Meadville Urology · Meadville, PA
Active · expires Mar 5, 2027
CLIA Number39D2009809
Laboratory TypePhysician Office
Certificate Effective DateMarch 6, 2025
Certificate Expiration DateMarch 5, 2027
Laboratory DirectorDr. Michael J. Martynik
Laboratory Phone(814) 373-2156
Laboratory LocationMeadville Urology765 Liberty Street, Suite 207, Meadville, PA 16335
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 2

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

KELSEY M SNYDER PA-C
Physician Assistant (Medical)
765 LIBERTY ST STE 207A
MEADVILLE, PA 16335
Crawford County (814) 373-2156
MARIE LYNN JOHNSON PA-C
Physician Assistant
765 LIBERTY ST STE 207A
MEADVILLE, PA 16335
Crawford County (814) 373-2156

Frequently Asked Questions

What is MEADVILLE MEDICAL CENTER's NPI number?

The NPI number assigned to this healthcare provider is 1841782869, enumerated as an "organization" on June 05, 2018.

Where is the provider located?

The provider is located at 765 LIBERTY ST STE 207A MEADVILLE, PA 16335 and the phone number is (814) 373-2156.

What is the provider's specialty?

Urology with taxonomy code 208800000X.