WELLSPAN MEDICAL GROUP (NPI# 1184784704) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184784704 |
| Entity Type | Organization |
| Organization Name | WELLSPAN MEDICAL GROUP |
| Other Organization Name | WELLSPAN INTERNAL MEDICINE - V TWIN DR |
| Practice Address |
40 V Twin Dr Ste 204 Gettysburg PA 17325-7878 |
| Mailing Address |
1803 Mount Rose Ave Suite B3 York PA 17403-3051 |
| Practice Telephone | 7173392424 |
| Practice Fax Number | 7173346659 |
| Mailing Telephone | 7178511405 |
| Mailing Fax Number | 7173346659 |
| Enumeration Date | 2006-12-12 |
| Last Update Date | 2016-04-04 |
| Authorized Official Name | MS. AMY F WILKINSON (CREDENTIALING COORDINATOR) |
| Authorized Official Telephone | 7178511405 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RG0300X |
Internal Medicine Specialization: Geriatric Medicine |
Allopathic & Osteopathic Physicians | ||
| Y | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | RAILROAD MEDICARE | CA3246 | 01 |
| PA | JOHN HOPKINS | 800174 | 01 |
| PA | HIGHMARK | 1382342 | 01 |
| PA | GEISINGER HEALTHPLAN | S1FC | 01 |
| PA | 1007721360120 | 05 | |
| PA | AMERIHEALTH 65 PA | 2073720001 | 01 |
| PA | UNISON | 132618 | 01 |
| PA | GATEWAY | 1512287 | 01 |
| PA | AETNA | 5092062 | 01 |
| MD | CAREFIRST BCBS | KX54 | 01 |
| PA | CAPITAL BLUE CROSS | 03150800 | 01 |
| PA | AMERIHEALTH MERCY | 20013267 | 01 |
| Other Name | Type Code |
|---|---|
| WellSpan Internal Medicine - V Twin Dr | Doing Business As Name - Organization |
| 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 |
| 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 |
| 1740249325 | Wellspan Medical Group | Counselor | 3550 Concord Road, York, PA 17402 | 2006-03-21 |
| Street Address |
40 V TWIN DR STE 204 |
| City | GETTYSBURG |
| State | PA |
| Zip Code | 17325-7878 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326290313 | Joanne E Smith | Nurse Practitioner | 40 V Twin Dr Ste 204, Gettysburg, PA 17325-7878 | 2008-10-21 |
| 1649443276 | Jason G Rahme | Internal Medicine | 40 V Twin Dr Ste 204, Gettysburg, PA 17325-7878 | 2008-04-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427684059 | Health Care Center LLC | Clinic/Center | 16e Hanover Street, Hanover St, Gettysburg, PA 17325 | 2020-03-16 |
| 1578039574 | Cpmoptometry LLC | Point of Service | Walmart Vision, 3271 Pa 940, Mt Pocono, PA 17325 | 2018-10-17 |
| 1306353933 | Hayley Michelle Kidd | Physical Therapist | 237 Savannah Dr, Gettysburg, PA 17325 | 2018-01-04 |
| 1700247582 | Renee Lehman LLC | Physical Therapist | 249 B York Street, Gettysburg, PA 17325 | 2016-03-08 |
| 1245664820 | Kera Joan Provost | Pharmacist | 40 V-twin Drive, Suite 107, Gettysburg, PA 17325 | 2013-08-30 |
| 1790922524 | Shannon Shutika | Physical Therapist | 867 York Road, Gettysburg, PA 17325 | 2009-01-15 |
| 1245489988 | Edward Mitchell O'brien | Acupuncturist | 2311 Fairfield Rd., Suite E, Gettysburg, PA 17325 | 2008-09-18 |
| 1184882011 | The Gettysburg Hospital-short Procedure | Clinic/Center | 450 South Washington St, Suite A, Gettysburg, PA 17325 | 2008-05-28 |
| 1619196227 | Susquehanna Optical Inc | Eyewear Supplier (Equipment, not the service) | 506 W. Middle St., Gettysburg, PA 17325 | 2007-04-24 |
| 1164542437 | John Martin Fidler | Prosthetic/Orthotic Supplier | 26 Baltimore St, Gettysburg, PA 17325 | 2007-03-30 |
| Find all providers in zip 17325 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235427246 | Graham Albert Foose | Internal Medicine | 455 S Washington St Ste 12, Gettysburg, PA 17325-2516 | 2011-07-12 |
| 1629206842 | Rajwinder Kaur | Internal Medicine | 147 Gettys Rd, Gettysburg, PA 17325-2534 | 2009-06-25 |
| 1700046190 | Elizabeth Le Wannebo | Internal Medicine | 1011 Boyds School Rd, Gettysburg, PA 17325-8580 | 2008-06-10 |
| 1982667754 | Mark P Diehl | Internal Medicine | 40 V-twin Dr, Suite 205, Gettysburg, PA 17325-7878 | 2006-04-11 |
| 1770583882 | John Richard Kalloz | Internal Medicine | 15 Ridgewood Ln, Gettysburg, PA 17325-8512 | 2005-07-29 |
| 1639177546 | Gettysburg Internal Medicine Associates, Inc. | Internal Medicine | 423 S Washington St, Gettysburg, PA 17325-2526 | 2005-07-13 |
| 1093179046 | Sabyr K Tabaldiev | Internal Medicine | 147 Gettys St, Gettysburg, PA 17325-2534 | 2016-04-06 |
| 1851779326 | Ahmed Zeb Khan | Internal Medicine | 147 Gettys St, Gettysburg, PA 17325-2534 | 2015-05-15 |
| 1558617480 | Liya Galooshian | Internal Medicine | 147 Gettys St, Gettysburg, PA 17325-2534 | 2012-07-30 |
| 1114280179 | Najeem Fazil Habibullah | Internal Medicine | 147 Gettys St, Gettysburg, PA 17325-2534 | 2012-06-24 |
| Find all providers in GETTYSBURG | ||||
| City | GETTYSBURG |
| Zip Code | 17325 |
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| 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.