WELLSPAN MEDICAL GROUP (NPI# 1669770004) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669770004 |
| Entity Type | Organization |
| Organization Name | WELLSPAN MEDICAL GROUP |
| Other Organization Name | WELLSPAN GASTROENTEROLOGY |
| Practice Address |
2350 Freedom Way Suite 200 York PA 17402-8200 |
| Mailing Address |
1803 Mount Rose Ave Suite B3 York PA 17403-3026 |
| Practice Telephone | 7178125120 |
| Practice Fax Number | 7177413075 |
| Mailing Telephone | 7178511405 |
| Mailing Fax Number | 7177419633 |
| Enumeration Date | 2011-03-09 |
| Last Update Date | 2015-12-23 |
| Authorized Official Name | MS. AMY F WILKINSON (CREDENTIALING SUPERVISOR) |
| Authorized Official Telephone | 7178125120 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | 1007721360299 | 05 | |
| PA | HIGHMARK BLUE SHIELD-WMG | 2598649 | 01 |
| PA | AETNA-WMG | 9203695 | 01 |
| MD | CAREFIRST MD BCBS-WMG | C8J5 | 01 |
| PA | AMERIHEALTH MERCY-WMG | 30088992 | 01 |
| PA | CAPITAL BLUE CROSS-WMG | 50099585 | 01 |
| PA | GATEWAY-WMG | 1593952 | 01 |
| Other Name | Type Code |
|---|---|
| WellSpan Gastroenterology | 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 |
2350 FREEDOM WAY SUITE 200 |
| City | YORK |
| State | PA |
| Zip Code | 17402-8200 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720086358 | Mark A Smith | Internal Medicine | 2350 Freedom Way, Suite 200, York, PA 17402-8200 | 2005-07-08 |
| 1134662943 | Gsh Home Med Care, LLC | Durable Medical Equipment & Medical Supplies | 2350 Freedom Way, Suite 206, York, PA 17402-8200 | 2016-11-28 |
| 1851833263 | Jessica C Halloran | Nurse Practitioner | 2350 Freedom Way, Suite 202, York, PA 17402-8200 | 2016-11-16 |
| 1770940868 | Wellspan Medical Group | Internal Medicine | 2350 Freedom Way, Suite 150, York, PA 17402-8200 | 2016-01-21 |
| 1154787729 | Cheryl Meyer | Nurse Practitioner | 2350 Freedom Way, York, PA 17402-8200 | 2016-01-12 |
| 1558733469 | Deborah Yommer | Nurse Practitioner | 2350 Freedom Way, Suite 202, York, PA 17402-8200 | 2015-10-30 |
| 1235509225 | Emily Susan Beach | Nurse Practitioner | 2350 Freedom Way, Suite 200, York, PA 17402-8200 | 2015-10-02 |
| 1639555139 | Maria Kostaris | Physician Assistant | 2350 Freedom Way, Suite 202, York, PA 17402-8200 | 2015-08-06 |
| 1821472820 | Rhonda M Steffen | Nurse Practitioner | 2350 Freedom Way, Suite 202, York, PA 17402-8200 | 2015-07-20 |
| 1447669445 | Lisa Senft | Nurse Practitioner | 2350 Freedom Way, Suite 202, York, PA 17402-8200 | 2014-08-05 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265053987 | Hope Renewed Counseling Services LLC | Social Worker | 879 Clare Lane, York, PA 17402 | 2020-05-04 |
| 1912462292 | Andventure, Inc. | Home Health | Andventure, Inc., 3415c Concord Rd., York, PA 17402 | 2019-01-31 |
| 1407327992 | Tariro Manamike | Pharmacist | Weis Markets Pharmacy, 2400 E Market Street, York, PA 17402 | 2018-12-10 |
| 1689120925 | Benjamin Stahle | Emergency Medicine | 70 Locust Grove Road, York, PA 17402 | 2016-08-28 |
| 1275905614 | Ultra Dental I, LLC | Dentist | 233 Pauline Drive, York, PA 17402 | 2015-10-26 |
| 1215323878 | Sonya Maria Korda | Dentist | 332 Shasta Dr., York, PA 17402 | 2015-04-10 |
| 1588909691 | Kimberly Sue Marsico | Counselor | 3110 East Market St, York, PA 17402 | 2012-11-29 |
| 1184995797 | Ivan Lewis Butler | General Practice | 204 St. Charles Way, Unit 364e, York, PA 17402 | 2012-01-13 |
| 1801117783 | Active Life Chiropractic | Chiropractor | 1915 E. Market Street, York, PA 17402 | 2010-06-15 |
| 1578881652 | Oss Orthopaedic Hospital, LLC | General Acute Care Hospital | 1861 Powder Mill Rd., York, PA 17402 | 2010-05-13 |
| Find all providers in zip 17402 | ||||
| Taxonomy Code | 207RG0100X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Gastroenterology |
| An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal 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 |
|---|---|---|---|---|
| 1881131472 | Paul Frey Spears | Internal Medicine | 490 Shady Dell Rd, York, PA 17403-4483 | 2017-01-20 |
| 1033362116 | Iain Lewis Mackenzie | Internal Medicine | 25 Monument Road Suite 250, Apple Hill Medical Center Digestive Disease Center, York, PA 17403 | 2008-11-03 |
| 1801086673 | Rafaz Hoque | Internal Medicine | 2350 Freedom Way Ste 200, York, PA 17402 | 2007-07-27 |
| 1942289046 | Duane E Ahlbrandt | Internal Medicine | 2690 Southfield Dr, York, PA 17403-4510 | 2006-01-17 |
| 1720086358 | Mark A Smith | Internal Medicine | 2350 Freedom Way, Suite 200, York, PA 17402-8200 | 2005-07-08 |
| 1265791412 | Ikenna Anaka | Internal Medicine | 2350 Freedom Way Ste 200, York, PA 17402 | 2012-05-09 |
| 1073888160 | Ryan R Croteau | Internal Medicine | 2350 Freedom Way Ste 200, York, PA 17402-8200 | 2012-03-21 |
| 1760772925 | Jatinder Goyal | Internal Medicine | 2350 Freedom Way Ste 200, York, PA 17402-8200 | 2011-04-08 |
| 1023343779 | Ali Abbas | Internal Medicine | 2690 Southfield Dr, York, PA 17403-4510 | 2009-10-14 |
| 1417105123 | Jaspreet Singh | Internal Medicine | 2350 Freedom Way, Suite 200, York, PA 17402-8200 | 2008-09-05 |
| Find all providers in YORK | ||||
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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.