Active NPI
Wellspan Medical Group
Doing business as WellSpan Family Medicine - Meadowbrook
- Family Medicine Physician
- Leola, PA
National Provider Identifier
1033660550
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- Legal business name
- WELLSPAN MEDICAL GROUP
- Doing business as
- WellSpan Family Medicine - Meadowbrook
- Practice address
- 368 W Main St
Suite 100
Leola, PA 17540-1761 - Phone
- (717) 656-6122
- Fax
- (717) 656-0142
- NPI assigned
- Oct 19, 2016
- Last updated
- Apr 6, 2023
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Laura Frank
- Title
- CVS-Manager
- Phone
- (717) 851-1405
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | Primary |
Addresses
Primary practice location
368 W Main St
Suite 100
Leola, PA 17540-1761
Mailing address
3421 Concord Rd
York, PA 17402-9001
Phone (717) 851-1405
Other names 1
- WellSpan Family Medicine - Meadowbrook
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040220000815 | PA | Part B Supplier - Clinic/Group Practice | 1951213115 |
Receives reassigned benefits from 3,390 practitioners This NPI is an additional NPI on the enrollment |
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 39D0188108 | Wellspan Family Medicine - Meadowbrook | Certificate of waiver | Apr 30, 2027 |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 25
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
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- York, PA
- NPI 1760064984
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-
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- York, PA
- NPI 1548355837
-
- Family Medicine Physician
- Greencastle, PA
- NPI 1588748941
-
- Neurology Physician
- Lewisburg, PA
- NPI 1154340461
-
- Physician Assistant
- Lebanon, PA
- NPI 1598394611
-
- Obstetrics & Gynecology Physician
- York, PA
- NPI 1801859699
-
- Physician Assistant
- York, PA
- NPI 1659708212
-
- Surgical Physician Assistant
- Ephrata, PA
- NPI 1588002109
-
- Medical Physician Assistant
- Greencastle, PA
- NPI 1891243275
-
- Family Medicine Physician
- Mifflinburg, PA
- NPI 1750546867
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1476835200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1680739200000",
"number": "1033660550",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3421 CONCORD RD",
"city": "YORK",
"state": "PA",
"postal_code": "174029001",
"telephone_number": "717-851-1405",
"fax_number": "717-851-6969"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "368 W MAIN ST",
"address_2": "SUITE 100",
"city": "LEOLA",
"state": "PA",
"postal_code": "175401761",
"telephone_number": "717-656-6122",
"fax_number": "717-656-0142"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "WELLSPAN MEDICAL GROUP",
"organizational_subpart": "NO",
"enumeration_date": "2016-10-19",
"last_updated": "2023-04-06",
"certification_date": "2023-03-31",
"status": "A",
"authorized_official_last_name": "FRANK",
"authorized_official_first_name": "LAURA",
"authorized_official_title_or_position": "CVS-MANAGER",
"authorized_official_telephone_number": "717-851-1405"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Family Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "WellSpan Family Medicine - Meadowbrook",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "WellSpan Family Medicine - Meadowbrook",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Leola, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.