WELLSPAN MEDICAL GROUP


Address: 101 Fairview Cir, Lebanon, PA 17042-9581
Phone: 7176392955

WELLSPAN MEDICAL GROUP (NPI# 1073166963) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1073166963
Entity Type Organization
Organization Name WELLSPAN MEDICAL GROUP
Practice Address 101 Fairview Cir
Lebanon
PA 17042-9581
Mailing Address 3421 Concord Rd
York
PA 17402-9001
Practice Telephone 7176392955
Practice Fax Number 7174617443
Mailing Telephone 7178511405
Mailing Fax Number 7174617443
Enumeration Date 2019-07-19
Last Update Date 2019-07-19
Authorized Official Name JULIANN DIAZ (CREDENTIALING SUPERVISOR)
Authorized Official Telephone 7178517134
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 208200000X Plastic Surgery Allopathic & Osteopathic Physicians

Other Provider/Organization Names

Other Name Type Code
WellSpan Breast Surgery Doing Business As Name - Organization

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1962980730 Wellspan Medical Group Thoracic Surgery (Cardiothoracic Vascular Surgery) 40 V Twin Dr Ste 102, Gettysburg, PA 17325-7878 2018-08-02
1245490515 Wellspan Medical Group Surgery 50 Wyntre Brooke Dr, York, PA 17403-4535 2008-06-11
1184784704 Wellspan Medical Group Internal Medicine 40 V Twin Dr Ste 204, Gettysburg, PA 17325-7878 2006-12-12
1801954276 Wellspan Medical Group Internal Medicine 296 St. Charles Way, York, PA 17402-4648 2006-12-05
1649348525 Wellspan Medical Group Physician Assistant 105 4th St # 727, East Berlin, PA 17316-9638 2006-12-01
1790853695 Wellspan Medical Group Family Medicine 4910a Fairfield Road, Fairfield, PA 17320-9510 2006-12-01
1801982426 Wellspan Medical Group Pain Medicine 140 Pine Grove Commons, York, PA 17403-5151 2006-10-04
1194819193 Wellspan Medical Group Neurological Surgery 228 Saint Charles Way, York, PA 17402-4644 2006-10-03
1740236900 Wellspan Medical Group Orthopaedic Surgery 18 Deatrick Drive, Gettysburg, PA 17325-6958 2006-05-26
1215994934 Wellspan Medical Group Family Medicine 924 Colonial Ave Ste B, York, PA 17403-3450 2006-04-27

Office Location

Street Address 101 FAIRVIEW CIR
City LEBANON
State PA
Zip Code 17042-9581

Providers in the same location

NPI Name Taxonomy Address Enumeration
1780683300 Samy B Gergis Family Medicine 101 Fairview Cir, Lebanon, PA 17042-9581 2005-07-15
1639620164 Wellspan Medical Group Family Medicine 101 Fairview Cir, Lebanon, PA 17042-9581 2016-10-19
1598159840 Jason Peter Assalita Family Medicine 101 Fairview Cir, Lebanon, PA 17042 2015-03-25
1821429994 Good Samaritan Physician Services Family Medicine 101 Fairview Cir, Lebanon, PA 17042-9581 2013-11-27
1366783540 Uchechi Amy Onyeyirim Registered Nurse 101 Fairview Cir, Lebanon, PA 17042-9581 2013-03-12
1609130129 Heather Feld Portaro Surgery 101 Fairview Cir, Lebanon, PA 17042 2012-06-28
1194953000 Amy Elizabeth Brose Physician Assistant 101 Fairview Cir, Lebanon, PA 17042-9581 2009-06-30
1679767693 Lisa Nicole Beck Helwig Family Medicine 101 Fairview Cir, Lebanon, PA 17042-9581 2007-09-03
1902957905 Kibibi Gaughan Family Medicine 101 Fairview Cir, Lebanon, PA 17042-9581 2007-01-16
1376505487 West Cornwall Family Practice, P.C. Family Medicine 101 Fairview Cir, Lebanon, PA 17042-9581 2006-04-04
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1023676384 Sandra L Pistone Registered Nurse 905 S. 2nd Ave, Lebanon, PA 17042 2019-06-03
1154848414 Kihc, LLC Home Health 900-c Centerville Road, Suite C, Lancaster, PA 17042 2017-08-28
1316301724 Good Samaritan Physician Services Radiology 844 Tuck Street, Lebanon, PA 17042 2016-04-12
1609265883 Ashley Hess Behavioral Analyst 15th South 9th Street, Lebanon, PA 17042 2015-01-12
1932504727 Anthony Salvadore Petrole Physician Assistant 252 4th Street, Lebanon, PA 17042 2014-10-23
1801209713 Matthew Johnson Family Medicine 920 Church Street, Lebanon, PA 17042 2014-06-09
1437414505 Odalys Gonzalez-rodriguez Physical Therapist 1700 S Lincoln Ave., Lebanon Vmac Bldg 102 Room 120, Lebanon, PA 17042 2012-07-05
1750677175 Anita Lyn Stokes Speech-Language Pathologist 1126 Walnut Street, Lebanon, PA 17042 2011-06-23
1205126497 Karey Lynn Foote Pharmacist 415 S. 9th St, Lebanon, PA 17042 2011-04-09
1013227685 T. W. Ponessa and Associates Counseling Services, Inc. Community/Behavioral Health 101 E. Evergreen Road, Lebanon, PA 17042 2010-10-18
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Taxonomy Information

Taxonomy Code 208200000X
Grouping Allopathic & Osteopathic Physicians
Classification Plastic Surgery

Taxonomy Definition

A plastic surgeon deals with the repair, reconstruction or replacement of physical defects of form or function involving the skin, musculoskeletal system, craniomaxillofacial structures, hand, extremities, breast and trunk and external genitalia or cosmetic enhancement of these areas of the body. Cosmetic surgery is an essential component of plastic surgery. The plastic surgeon uses cosmetic surgical principles to both improve overall appearance and to optimize the outcome of reconstructive procedures. The surgeon uses aesthetic surgical principles not only to improve undesirable qualities of normal structures but in all reconstructive procedures as well.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Plastic Surgery, 2007. http://www.abplsurg.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Plastic Surgery.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1629042015 Jame Francis Arnold Plastic Surgery 419 S 3rd St, Lebanon, PA 17042 2006-02-14
1285899666 Earl Dwayne Lett, PC Plastic Surgery 1417 W Baddour Pkwy, Suite B, Lebanon, TN 37087-2513 2008-07-24
1578766986 Lebanon Plastic Surgery Associates P C Plastic Surgery 419 S 3rd St, Lebanon, PA 17042-6204 2007-06-06
1598848699 John Francis Nigriny Plastic Surgery 1 Medical Center Dr, Dhmc - Department of Plastic Surgery, Lebanon, NH 03756-1000 2006-10-23
1912015215 Joseph Mark Rosen Plastic Surgery 1 Medical Center Drive, Lebanon, NH 03756 2006-08-27
1497775456 Mitchell Andrew Stotland Plastic Surgery 1 Medical Center Dr, Lebanon, NH 03756-1000 2006-07-20
1073532636 Carolyn Kerrigan Plastic Surgery 1 Medical Center Dr, Lebanon, NH 03756-1000 2006-07-18
1639198138 Dale Collins Vidal Plastic Surgery 127 Mascoma St, Lebanon, NH 03766-2661 2006-07-18
1811971807 Joseph H Shin Plastic Surgery 1 Medical Center Dr, Plastic & Reconstructive Surgery, Lebanon, NH 03756-1000 2005-12-02

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1588298418 Grunwaldt Falbo Pllc Plastic Surgery 873 Bebout Rd, Venetia, PA 15367-1215 2020-03-01
1528606654 Everest Medspa LLC Plastic Surgery 6787 Market St Ste 106, Upper Darby, PA 19082-1848 2019-12-19
1851939771 Ericka Culp Plastic Surgery 5750 Centre Ave Ste 360, Pittsburgh, PA 15206-3761 2019-12-11
1346742871 Andrea Kristin Chamberlain Plastic Surgery 1614 Washington Rd, Pittsburgh, PA 15241-1210 2018-02-28
1205348141 Kp Aesthetics, LLC. Plastic Surgery 4675 W Chester Pike, Newtown Square, PA 19073-2227 2017-11-01
1346765229 Denise M. Kenna, M.d. Plastic Surgery 2350 Freedom Way Ste 107, York, PA 17402-8200 2017-08-11
1467973305 Hr Physician Services Plastic Surgery 3300 Tillman Dr Ste 201, Bensalem, PA 19020-2071 2017-06-30
1598293979 Andrea Rae Hiller Plastic Surgery 500 University Dr # Mch071, Hershey, PA 17033 2017-05-30
1295116473 Shagun Aggarwal Plastic Surgery 3400 Civic Center Blvd Fl 7, Division of Plastic Surgery, University of Pennsylvania, Philadelphia, PA 19104-5163 2015-06-14
1598152852 Brenton Robinson Plastic Surgery 3550 Terrace Street Scaife Hall Suite 668, Pittsburgh, PA 15261-5640 2015-04-23
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Competitor

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City LEBANON
Zip Code 17042

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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