OrganizationActive
Upmc Community Medicine
NPI 1013316553 · Non-Pharmacy Dispensing Site · Conneaut Lake, PA
Upmc Community Medicine is a Non-Pharmacy Dispensing Site organization in Conneaut Lake, PA (NPI 1013316553).
Provider details
- NPI number
- 1013316553
- Entity type
- Organization
- Primary specialty
- Non-Pharmacy Dispensing SiteSuppliers
- Parent organization
- Medvantx, Inc
- Organization subpart
- Yes
- Authorized official
- Kenny Heine, Vp of Operations(858) 964-1506
- License
- OS012755 (PA)
Specialties & taxonomies
Suppliers
Profile Score
Detailed profile(75/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
11 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
11065 State Highway 18
Suite 1
Conneaut Lake, PA 16316-3569
Phone: (814) 382-6550
Street-level locationGet directions
Mailing address
5626 Oberlin Dr
San Diego, CA 92121-1705
Other names (DBA / former)
- Doing business as
- Lakeside Family Medicine Conneaut Lake
Registry dates
- Enumerated
- 2014-08-21
- Last updated
- 2014-08-21
Frequently asked questions
- What is Upmc Community Medicine's NPI number?
- Upmc Community Medicine's National Provider Identifier (NPI) is 1013316553, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Upmc Community Medicine?
- Upmc Community Medicine is classified in the NPPES registry as Non-Pharmacy Dispensing Site (Suppliers).
- Where is Upmc Community Medicine located?
- Upmc Community Medicine's practice location on file with NPPES is 11065 State Highway 18, Conneaut Lake, PA 16316-3569.
- What is Upmc Community Medicine's phone number?
- The practice phone number listed in the NPPES registry for Upmc Community Medicine is (814) 382-6550.
- Who is the authorized official for Upmc Community Medicine?
- The authorized official listed on Upmc Community Medicine's NPPES record is Kenny Heine, Vp of Operations. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Upmc Community Medicine's NPI active?
- Yes — Upmc Community Medicine's NPI (1013316553) is active in the NPPES registry as of the last update on 2014-08-21.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.