OrganizationActive
Fayette Physician Network Inc
NPI 1053704429 · Non-Pharmacy Dispensing Site · Masontown, PA
Fayette Physician Network Inc is a Non-Pharmacy Dispensing Site organization in Masontown, PA (NPI 1053704429).
Provider details
- NPI number
- 1053704429
- 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
- MD417327 (PA)
Specialties & taxonomies
Suppliers
Profile Score
Established profile(74/100 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
2175 Mcclellandtown Rd
Masontown, PA 15461-2593
Phone: (724) 583-2819
Street-level locationGet directions
Mailing address
5626 Oberlin Dr
San Diego, CA 92121-1705
Other names (DBA / former)
- Doing business as
- Fayette Physician Network-Masontown
Registry dates
- Enumerated
- 2015-03-10
- Last updated
- 2015-03-10
Frequently asked questions
- What is Fayette Physician Network Inc's NPI number?
- Fayette Physician Network Inc's National Provider Identifier (NPI) is 1053704429, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Fayette Physician Network Inc?
- Fayette Physician Network Inc is classified in the NPPES registry as Non-Pharmacy Dispensing Site (Suppliers).
- Where is Fayette Physician Network Inc located?
- Fayette Physician Network Inc's practice location on file with NPPES is 2175 Mcclellandtown Rd, Masontown, PA 15461-2593.
- What is Fayette Physician Network Inc's phone number?
- The practice phone number listed in the NPPES registry for Fayette Physician Network Inc is (724) 583-2819.
- Who is the authorized official for Fayette Physician Network Inc?
- The authorized official listed on Fayette Physician Network Inc'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 Fayette Physician Network Inc's NPI active?
- Yes — Fayette Physician Network Inc's NPI (1053704429) is active in the NPPES registry as of the last update on 2015-03-10.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.