HONESDALE PEDIATRIC CENTER
NPI 1932751187
Clinic/Center - Federally Qualified Health Center (FQHC) in Honesdale, PA

Q: What is Wayne Memorial Community Health Centers's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Federally Qualified Health Center (FQHC), with taxonomy code 261QF0400X.

Active since July 09, 2019CLIA 39D0714542 · Waiver

1837 FAIR AVE, HONESDALE, PA 18431(570) 253-5838(570) 253-6678 Get Directions Write a Review

NPPES record last updated: August 28, 2020. Verified against the NPPES registry weekly; last sync: August 23, 2026.

Record update history: Aug 28, 2020, Jul 10, 2019 (2 updates tracked since 2019).

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About Honesdale Pediatric Center NPPES

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

HONESDALE PEDIATRIC CENTER (NPI 1932751187) is a healthcare organization registered as a federally qualified health center (fqhc) in Honesdale, Pennsylvania and active in the NPI registry since July 2019. The organization holds a CLIA Waiver certificate valid through October 9, 2026 and lists Frederick Jackson, Executive Director, as its authorized official.

NPPES Registry Identity

NPI1932751187

Entity TypeOrganization

Primary Taxonomy261QF0400X

Legal Business NameWAYNE MEMORIAL COMMUNITY HEALTH CENTERS

Location Address1837 FAIR AVEHonesdale, PA 18431-2121

Mailing Address601 Park StHonesdale, PA 18431-1445 · (570) 253-8226 · Fax (570) 253-8228

Phone(570) 253-5838

Fax(570) 253-6678

Organization SubpartNo

Authorized OfficialFrederick JacksonExecutive Director · (570) 253-8450

Enumeration DateJuly 9, 2019

Last NPPES UpdateAugust 28, 20202 updates tracked since enumeration

NPPES CertifiedAugust 28, 2020

✔ NPI 1932751187 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyClinic/Center · Federally Qualified Health Center (FQHC)Ambulatory Health Care Facilities

Taxonomy Code261QF0400X

Also ListedPediatricsTaxonomy 208000000X

1837 FAIR AVE, Honesdale, PA 18431

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Other Names 1

Doing Business AsHonesdale Pediatric Center

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

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter Health, Ambetter Health of Delaware.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 39D0714542

Honesdale Pediatric Center · Honesdale, PA

Active · expires Oct 9, 2026

CLIA Number39D0714542

Laboratory TypePhysician Office

Certificate Effective DateOctober 10, 2024

Certificate Expiration DateOctober 9, 2026

Laboratory DirectorDr. Meredith L. Hellstern

Laboratory Phone(570) 253-5838

Laboratory LocationHonesdale Pediatric Center1837 Fair Ave, Honesdale, PA 18431

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 7

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

MS. GWEN E MILLER PA-C

Physician Assistant