GOOD SAMARITAN PHYSICIAN SERVICE (NPI# 1932513397) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932513397 |
| Entity Type | Organization |
| Organization Name | GOOD SAMARITAN PHYSICIAN SERVICE |
| Other Organization Name | WELLSPAN PULMONARY AND SLEEP MEDICINE - LEBANON |
| Practice Address |
850 Tuck St Lebanon PA 17042-7477 |
| Mailing Address |
Po Box 300 Lebanon PA 17042-0300 |
| Practice Telephone | 7172728173 |
| Practice Fax Number | 7172724029 |
| Mailing Telephone | 7172707780 |
| Mailing Fax Number | 7172749746 |
| Enumeration Date | 2014-06-13 |
| Last Update Date | 2016-10-05 |
| Authorized Official Name | JODY M BOGER (CREDENTIALING COORDINATOR) |
| Authorized Official Telephone | 7172707780 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RP1001X |
Internal Medicine Specialization: Pulmonary Disease |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | 001864024 | 05 |
| Other Name | Type Code |
|---|---|
| WellSpan Pulmonary and Sleep Medicine - Lebanon | Other Name - Individual/Organization |
| Street Address |
850 TUCK ST |
| City | LEBANON |
| State | PA |
| Zip Code | 17042-7477 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568437127 | Sergei L Joffy | Hospitalist | 850 Tuck St, Lebanon, PA 17042-7477 | 2006-02-17 |
| 1265967616 | Vivian E Henry | Nurse Practitioner | 850 Tuck St, Lebanon, PA 17042-7477 | 2017-04-24 |
| 1114467347 | Melissa Baldwin | Nurse Practitioner | 850 Tuck St, Lebanon, PA 17042-7477 | 2017-03-07 |
| 1720359680 | Qammar Abbas | Internal Medicine | 850 Tuck St, Lebanon, PA 17042-7477 | 2012-01-24 |
| 1588843866 | Bedilu W Woldaregay | Internal Medicine | 850 Tuck St, Lebanon, PA 17042 | 2007-11-02 |
| 1891906103 | Maryam Gul | Internal Medicine | 850 Tuck St, Lebanon, PA 17042-7477 | 2007-05-25 |
| 1912921115 | Wilson S Morris Jr. | Internal Medicine | 850 Tuck St, Lebanon, PA 17042-7477 | 2006-07-27 |
| 1467474692 | Raymond R Beatty Jr. | Internal Medicine | 850 Tuck St, Lebanon, PA 17042-7477 | 2006-07-24 |
| 1184645509 | Leona Ewing | Pediatrics | 850 Tuck St, Lebanon, PA 17042-7477 | 2006-07-21 |
| 1689695033 | Mary Timm Hinkle | Nurse Practitioner | 850 Tuck St, Lebanon, PA 17042-7477 | 2006-07-21 |
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| 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 |
| Find all providers in zip 17042 | ||||
| Taxonomy Code | 207RP1001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Pulmonary Disease |
| An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs. |
| 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 |
|---|---|---|---|---|
| 1629160296 | Ashok Khattri | Internal Medicine | 1700,lincoln Ave, Lebanon Vamc, Lebanon, PA 17042 | 2006-09-29 |
| 1346576246 | Graham Thomas Atkins | Internal Medicine | 1 Medical Center Dr, Dhmc, Department of Pulmonary Medicine, Lebanon, NH 03756 | 2009-10-27 |
| 1598995086 | Adam Anthony Cieciuch | Internal Medicine | 2705 N Lebanon St Ste 265, Lebanon, IN 46052-8621 | 2009-07-20 |
| 1588843866 | Bedilu W Woldaregay | Internal Medicine | 850 Tuck St, Lebanon, PA 17042 | 2007-11-02 |
| 1346449667 | Mitsuo Matsuoka | Internal Medicine | 1 Medical Center Dr, Dhmc, Department of Medicine, Section of Pulmonary, Lebanon, NH 03756-1000 | 2007-07-16 |
| 1932234325 | Christopher James Huffer | Internal Medicine | 2605 N Lebanon St, Lebanon, IN 46052-1476 | 2007-02-23 |
| 1609952761 | The Good Samaritan Hospital | Internal Medicine | Fourth and Walnut Streets, Lebanon, PA 17042 | 2006-10-31 |
| 1265512545 | James Carrington Leiter IIi | Internal Medicine | 1 Medical Center Dr, Lebanon, NH 03756-1000 | 2006-10-17 |
| 1518075159 | Donald A Mahler | Internal Medicine | 1 Medical Center Dr, Dhmc Pulmonary, Lebanon, NH 03756-1000 | 2006-08-25 |
| 1346356367 | Henry Worth Parker | Internal Medicine | 1 Medical Center Dr, Lebanon, NH 03756-1000 | 2006-08-22 |
| 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.