NPIMap

Organization Active NPI

Evangelical Medical Services Organization

  • Emergency Medicine Physician
  • Lewisburg, PA
National Provider Identifier
1073613345
Registry record updated Sep 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
EVANGELICAL MEDICAL SERVICES ORGANIZATION
Practice address
1 Hospital Dr
Lewisburg, PA 17837-9314
Phone
(570) 522-4110
Fax
(570) 522-4120
NPI assigned
Sep 25, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2024

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

Authorized official

Name
Kendra A Aucker
Title
Senior Vice President/President
Phone
(570) 522-2807

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207P00000X PA Primary

Addresses

Primary practice location

1 Hospital Dr
Lewisburg, PA 17837-9314

Mailing address

1 Hospital Dr
Lewisburg, PA 17837-9314
Phone (570) 522-4110

Other identifiers 2

IdentifierTypeStateIssuer
1957577OtherPAHIGHMARK BLUE SHIELD
3229300OtherPACAPITAL BLUE CROSS

Other names 1

  • WellSpan Emergency Medicine Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040310000212 PA Part B Supplier - Clinic/Group Practice 9133033087 Receives reassigned benefits from 372 practitioners
7 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Lewisburg, PA; Middleburg, PA; Mifflinburg, PA; Milton, PA; New Columbia, PA; Northumberland, PA; Selinsgrove, PA; Shamokin Dam, PA…

Other NPIs on the same Medicare enrollment 7

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 32

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 32

NPI Registry JSON

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1725580800000",
    "number": "1073613345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 HOSPITAL DR",
            "city": "LEWISBURG",
            "state": "PA",
            "postal_code": "178379314",
            "telephone_number": "570-522-4110",
            "fax_number": "570-522-4120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 HOSPITAL DR",
            "city": "LEWISBURG",
            "state": "PA",
            "postal_code": "178379314",
            "telephone_number": "570-522-4110",
            "fax_number": "570-522-4120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVANGELICAL MEDICAL SERVICES ORGANIZATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-25",
        "last_updated": "2024-09-06",
        "certification_date": "2024-09-06",
        "status": "A",
        "authorized_official_last_name": "AUCKER",
        "authorized_official_first_name": "KENDRA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "SENIOR VICE PRESIDENT/PRESIDENT",
        "authorized_official_telephone_number": "570-522-2807"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "1957577",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPITAL BLUE CROSS",
            "identifier": "3229300",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WellSpan Emergency Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lewisburg, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.