NPIMap

Organization Active NPI

Lancaster General Medical Group

Doing business as Penn Medicine LGHP Women's Internal Medicine

  • Internal Medicine Physician
  • Lancaster, PA
National Provider Identifier
1053702233
Registry record updated Nov 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
LANCASTER GENERAL MEDICAL GROUP
Doing business as
Penn Medicine LGHP Women's Internal Medicine
Practice address
690 Good Drive
Women's Outpatient Center 2ND FLR
Lancaster, PA 17601-2433
Phone
(717) 544-0740
Fax
(717) 544-0739
NPI assigned
Feb 10, 2015
Last updated
Nov 16, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Denise A Kennedy
Title
VP Financial Services
Phone
(717) 544-5010

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X NU Primary

Addresses

Primary practice location

690 Good Drive
Women's Outpatient Center 2ND FLR
Lancaster, PA 17601-2433

Mailing address

690 Good Drive
Women's Outpatient Center 2ND FLR
Lancaster, PA 17601-2433
Phone (717) 544-0740

Other names 1

  • Penn Medicine LGHP Women's Internal Medicine Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Cobius Healthcare Solutions

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040309000916 PA Part B Supplier - Clinic/Group Practice 0941103683 Receives reassigned benefits from 886 practitioners
This NPI is an additional NPI on the enrollment

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
39D2101667Women's Internal Medicine690 Good Drive, Second Floor, Lancaster, PA 17601Certificate of waiverSep 7, 2027

National Provider Directory

National Provider Directory

Locations

690 Good Dr
Fl 2
Lancaster, PA 17601
Phone (717) 544-0700

Practitioners & affiliated clinicians

Practitioners 11

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1423526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1605484800000",
    "number": "1053702233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "690 GOOD DRIVE",
            "address_2": "WOMEN'S OUTPATIENT CENTER 2ND FLR",
            "city": "LANCASTER",
            "state": "PA",
            "postal_code": "176012433",
            "telephone_number": "717-544-0740",
            "fax_number": "717-544-0739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "690 GOOD DRIVE",
            "address_2": "WOMEN'S OUTPATIENT CENTER 2ND FLR",
            "city": "LANCASTER",
            "state": "PA",
            "postal_code": "176012433",
            "telephone_number": "717-544-0740",
            "fax_number": "717-544-0739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LANCASTER GENERAL MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-10",
        "last_updated": "2020-11-16",
        "certification_date": "2020-11-16",
        "status": "A",
        "authorized_official_last_name": "KENNEDY",
        "authorized_official_first_name": "DENISE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "VP FINANCIAL SERVICES",
        "authorized_official_telephone_number": "717-544-5010"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1068.1",
            "affiliationName": "Cobius Healthcare Solutions",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "2720 Dundee Rd # 302",
            "city": "Northbrook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600622609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Penn Medicine LGHP Women's Internal Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lancaster, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2020; 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.

Verify at the official NPI Registry.