WELLSPAN MEDICAL GROUP (NPI# 1356892889) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356892889 |
| Entity Type | Organization |
| Organization Name | WELLSPAN MEDICAL GROUP |
| Other Organization Name | WELLSPAN FAMILY MEDICINE - NORTH FOURTH STREET |
| Practice Address |
30 N 4th St 2nd Fl Lebanon PA 17046-5606 |
| Mailing Address |
3421 Concord Rd York PA 17402-9001 |
| Practice Telephone | 7172740474 |
| Practice Fax Number | 7172740673 |
| Mailing Telephone | 7178511405 |
| Mailing Fax Number | 7178516969 |
| Enumeration Date | 2016-10-19 |
| Last Update Date | 2016-10-19 |
| Authorized Official Name | CHRISTINA MOON (SUPERVISOR-VERIFICATION SERVICES) |
| Authorized Official Telephone | 7178511405 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207V00000X | Obstetrics & Gynecology | Allopathic & Osteopathic Physicians | ||
| N | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians | ||
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| WellSpan Family Medicine - North Fourth Street | 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 |
| 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 |
| Street Address |
30 N 4TH ST 2ND FL |
| City | LEBANON |
| State | PA |
| Zip Code | 17046-5606 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275513814 | Jane Zendarski | Acupuncturist | 30 N 4th St, Lebanon, PA 17046-5606 | 2006-01-19 |
| 1174133433 | Mobeena Arif | Family Medicine | 30 N 4th St, Lebanon, PA 17046-5606 | 2020-08-03 |
| 1619594462 | Marta Halytska | Family Medicine | 30 N 4th St, Lebanon, PA 17046-5606 | 2020-06-28 |
| 1528682887 | Francis Guerra-bauman | Family Medicine | 30 N 4th St, Lebanon, PA 17046-5606 | 2020-06-02 |
| 1447872189 | Asna Tasleem | Family Medicine | 30 N 4th St, Lebanon, PA 17046-5606 | 2020-05-16 |
| 1053933879 | Muhammad Ali Chaudhary | Family Medicine | 30 N 4th St, Lebanon, PA 17046-5606 | 2020-05-14 |
| 1043831563 | Sobia Zareen | Family Medicine | 30 N 4th St, Lebanon, PA 17046-5606 | 2020-05-06 |
| 1063033223 | Anila Gidwani | Physical Therapist | 30 N 4th St, Lebanon, PA 17046-5606 | 2020-04-29 |
| 1154982221 | Trajan Barrera | Family Medicine | 30 N 4th St, Lebanon, PA 17046-5606 | 2019-06-27 |
| 1750942900 | Derek J Baughman | Family Medicine | 30 N 4th St, Lebanon, PA 17046-5606 | 2019-06-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568708972 | Amy Lesher | Counselor | 200 N &th Street, Lebanon, PA 17046 | 2012-12-13 |
| 1053656033 | Jessica L Hoffman | Nutritionist | 4053 Church Hill Road, Lebanon, PA 17046 | 2012-12-03 |
| 1568772135 | T. W. Ponessa and Associates Counseling Services, Inc. | Community/Behavioral Health | 400 Narrows Drive, Lebanon, PA 17046 | 2010-10-18 |
| 1336213024 | William Lee Huffman | Optometrist | 40 N 8th St, Lebanon, PA 17046 | 2006-11-17 |
| 1366534620 | Pennsylvania Counseling Services Inc | Counselor | 200 N 7th St., Lebanon, PA 17046 | 2006-09-28 |
| 1922106541 | Pennsylvania Cvs Pharmacy, L.L.C. | Durable Medical Equipment & Medical Supplies | 833 Bowman St The Promenade At Lebanon E, Lebanon, PA 17046 | 2006-09-20 |
| 1457360471 | Lebanon Oncology & Hematology Assoc. | Internal Medicine | 4th & Willow St, Hyman S Caplan Pavilion, Lebanon, PA 17046 | 2006-08-07 |
| 1942218987 | Craig M Wilson | Chiropractor | 624 N Ninth Street, Family Care Chiropractic, Lebanon, PA 17046 | 2006-08-04 |
| 1477575975 | John I Shearer | Counselor | 1560 Jody Ave, Lebanon, PA 17046 | 2006-07-24 |
| 1316921950 | Deborah J Thomas | Counselor | 408 N 15th Ave, Lebanon, PA 17046 | 2005-12-06 |
| Find all providers in zip 17046 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134604606 | Stayton Family Practice Inc | Family Medicine | 41 E Ash St, Lebanon, OR 97355-3317 | 2018-10-01 |
| 1033693031 | Heather Heck | Family Medicine | 1701 Cornwal Road, Lebanon, PA 17042-7480 | 2018-09-17 |
| 1982113148 | A1 Health Care Clinic | Family Medicine | 703 East Main Street, # 8, Lebanon, KY 40444 | 2017-09-20 |
| 1952830127 | Juliana Zamora Cubillos | Family Medicine | 120 Hospital Dr Ste 100, Lebanon, MO 65536-9227 | 2017-06-09 |
| 1245781954 | Mountain States Health Alliance | Family Medicine | 58 Carroll St Suite 3, Dept of Russell County Medical Center, Lebanon, VA 24266 | 2016-10-18 |
| 1982080255 | Dawn Barker | Family Medicine | 331 Hospital Dr Ste C, Lebanon, MO 65536 | 2015-08-10 |
| 1467848952 | Kelly Renee Deatley | Family Medicine | 325 W Walnut St Ste 600, Lebanon, KY 40033 | 2015-04-10 |
| 1801209713 | Matthew Johnson | Family Medicine | 920 Church Street, Lebanon, PA 17042 | 2014-06-09 |
| 1407288210 | Healthsource of Ohio, Inc. | Family Medicine | 1231 Columbus Ave, Unit A 1, Lebanon, OH 45036-8195 | 2013-08-02 |
| 1598108763 | Docare,llc | Family Medicine | 680 E Grant St, Lebanon, OR 97355-4432 | 2013-04-08 |
| Find all providers in LEBANON | ||||
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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.