{"npi":"1164064002","type":"NPI-2","status":"active","name":{"display":"Centerville Clinics INC","other":[],"organization_name":"CENTERVILLE CLINICS INC","authorised_official":"Barry Niccolai"},"specialty":{"primary_taxonomy":"261QF0400X","primary_taxonomy_description":"Federally Qualified Health Center","slug":"fqhc","schema_org_specialty":"PrimaryCare","all":[{"code":"207Q00000X","description":"Family Medicine","primary":false,"state":null,"license":null},{"code":"261QF0400X","description":"Federally Qualified Health Center","primary":true,"state":null,"license":null}]},"addresses":[{"purpose":"LOCATION","street_1":"CENTERVILLE CLINICS-DONORA FAMILY MEDICINE","city":"DONORA","state":"PA","postal_code":"150331061","country_code":"US","street_2":"718 MCKEAN AVENUE","phone":"7243794401"},{"purpose":"MAILING","street_1":"CENTERVILLE CLINICS INC","city":"FREDERICKTOWN","state":"PA","postal_code":"153332114","country_code":"US","street_2":"1070 OLD NATIONAL PIKE ROAD","phone":"7246326801","fax":"7246326312"}],"license":null,"identifiers":[{"type_code":"05","label":"Medicaid","value":"1007288440027","state":"PA","issuer":null}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"O20210217003122","type_code":"00-04","type_desc":"PART A PROVIDER - FEDERALLY QUALIFIED HEALTH CENTER (FQHC)","state":"PA","pac_id":"7214837202"}]},"enumeration_date":"2019-10-11","last_updated":"2019-10-11","_meta":{"source":"NPPES","snapshot_date":"2019-10-11","doc_url":"https://findmynpi.com/api"}}