WELLSPAN MEDICAL GROUP (NPI# 1740249325) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740249325 |
| Entity Type | Organization |
| Organization Name | WELLSPAN MEDICAL GROUP |
| Other Organization Name | WELLSPAN PHILHAVEN |
| Practice Address |
3550 Concord Road York PA 17402 |
| Mailing Address |
3421 Concord Rd York PA 17402-9001 |
| Practice Telephone | 7178516340 |
| Practice Fax Number | 7178516349 |
| Mailing Telephone | 7178124200 |
| Mailing Fax Number | 7178454791 |
| Enumeration Date | 2006-03-21 |
| Last Update Date | 2018-01-11 |
| Authorized Official Name | MS. CHRISTINA VEST (CREDENTIALING SUPERVISOR) |
| Authorized Official Telephone | 7178516586 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101Y00000X | Counselor | Behavioral Health & Social Service Providers | ||
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers | ||
| N | 103G00000X | Clinical Neuropsychologist | Behavioral Health & Social Service Providers | ||
| N | 103T00000X | Psychologist | Behavioral Health & Social Service Providers | ||
| N | 104100000X | Social Worker | PA | Behavioral Health & Social Service Providers | |
| N | 1041C0700X |
Social Worker Specialization: Clinical |
Behavioral Health & Social Service Providers | ||
| N | 2084A0401X |
Psychiatry & Neurology Specialization: Addiction Medicine |
Allopathic & Osteopathic Physicians | ||
| N | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
Allopathic & Osteopathic Physicians | ||
| N | 2084N0402X |
Psychiatry & Neurology Specialization: Neurology with Special Qualifications in Child Neurology |
Allopathic & Osteopathic Physicians | ||
| N | 2084P0005X |
Psychiatry & Neurology Specialization: Neurodevelopmental Disabilities |
Allopathic & Osteopathic Physicians | ||
| N | 2084P0802X |
Psychiatry & Neurology Specialization: Addiction Psychiatry |
Allopathic & Osteopathic Physicians | ||
| N | 2084P0804X |
Psychiatry & Neurology Specialization: Child & Adolescent Psychiatry |
Allopathic & Osteopathic Physicians | ||
| N | 2084P0805X |
Psychiatry & Neurology Specialization: Geriatric Psychiatry |
Allopathic & Osteopathic Physicians | ||
| N | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CAPITAL BLUE CROSS | 02303700 | 01 | |
| PA | CIGNA BEHAVIORAL HEALTH | 2081591 | 01 |
| PA | CIGNA BEHAVIORAL HEALTH | 2081597 | 01 |
| PA | MANAGED HEALTH NETWORK | 306906 | 01 |
| PA | 100772136 0360 | 05 | |
| PA | BLUE SHIELD | 1681714 | 01 |
| PA | CIGNA BEHAVIORAL HEALTH | 2148186 | 01 |
| PA | BLUE SHIELD | 925715 | 01 |
| PA | BUE SHIELD | 925716 | 01 |
| PA | BLUE SHIELD | 2091237 | 01 |
| PA | 100772136 | 05 | |
| PA | CIGNA BEHAVIORAL HEALTH | 2081595 | 01 |
| PA | AETNA | 7162248 | 01 |
| PA | CIGNA BEHAVIORAL HEALTH | 2164697 | 01 |
| Other Name | Type Code |
|---|---|
| WELLSPAN PHILHAVEN | 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 |
3550 CONCORD ROAD |
| City | YORK |
| State | PA |
| Zip Code | 17402 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780988188 | Kimberlee A Loch | Nurse Practitioner | 3550 Concord Road, York, PA 17402-4829 | 2010-12-29 |
| 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 | 2084P0800X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Psychiatry |
| A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104243096 | Nikita Eike | Psychiatry & Neurology | 707 Loucks Rd, York, PA 17404-1730 | 2014-03-28 |
| 1972932085 | Lulo Universitas Life Observatory, LLC | Psychiatry & Neurology | 25 N Duke St, Suite 207, York, PA 17401-1289 | 2013-11-08 |
| 1548698103 | Marilyn Adam | Psychiatry & Neurology | 1120 Turnberry Ln, York, PA 17403-9115 | 2013-10-17 |
| 1881845212 | Eugene A Glick | Psychiatry & Neurology | 9 Linden Ln, York, ME 03909-1344 | 2008-10-03 |
| 1780835306 | Leslie Albert | Psychiatry & Neurology | 166 Dew Drop Rd, Apt P, York, PA 17402 | 2008-10-01 |
| 1376603597 | Jeffrey William Hermann | Psychiatry & Neurology | 300 E 7th Ave, York, PA 17404-2105 | 2006-12-11 |
| 1164502191 | Mary Elizabeth Rahn | Psychiatry & Neurology | 8 Wyntre Brooke Dr, York, PA 17403 | 2006-10-16 |
| 1700810934 | Yury Yaroslavsky | Psychiatry & Neurology | 401 Carlisle Ave, York, PA 17404-3241 | 2006-07-11 |
| 1144264953 | Jimmy O Ibikunle | Psychiatry & Neurology | 2078 Bernays Dr, York, PA 17404-1493 | 2006-06-15 |
| 1669415691 | Peter M Hartmann | Psychiatry & Neurology | 1600 S George St, York, PA 17403-4508 | 2006-06-14 |
| 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.