NPIMap

Organization Active NPI

Lancaster General Medical Group

Doing business as Penn Medicine LGHP Podiatry

  • Podiatrist
  • Parkesburg, PA
National Provider Identifier
1073908323
Registry record updated Nov 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
Legal business name
LANCASTER GENERAL MEDICAL GROUP
Doing business as
Penn Medicine LGHP Podiatry
Practice address
950 S Octorara Trail
Suite 160/170
Parkesburg, PA 19365-2100
Phone
(866) 871-0851
Fax
(610) 857-6638
NPI assigned
Apr 3, 2015
Last updated
Nov 6, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2019

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

Authorized official

Name
Denise Kennedy
Title
Vice President Financial Services
Phone
(717) 544-5010

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X NU Primary
Foot & Ankle Surgery Podiatrist 213ES0103X NU

Addresses

Primary practice location

950 S Octorara Trail
Suite 160/170
Parkesburg, PA 19365-2100

Mailing address

950 S Octorara Trail
Suite 160/170
Parkesburg, PA 19365-2100
Phone (866) 871-0851

Other names 1

  • Penn Medicine LGHP Podiatry Doing business as

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

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

101 Abbeyville Rd
Lancaster, PA 17603
Phone (717) 291-5991

2108 Harrisburg Pike
Ste 310
Lancaster, PA 17601
Phone (717) 291-5991

950 S Octorara Trl
Ste 160170
Parkesburg, PA 19365
Phone (610) 857-6639

Practitioners & affiliated clinicians

Practitioners 19

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.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1428019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1572998400000",
    "number": "1073908323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "950 S OCTORARA TRAIL",
            "address_2": "SUITE 160/170",
            "city": "PARKESBURG",
            "state": "PA",
            "postal_code": "193652100",
            "telephone_number": "866-871-0851",
            "fax_number": "610-857-6638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 S OCTORARA TRAIL",
            "address_2": "SUITE 160/170",
            "city": "PARKESBURG",
            "state": "PA",
            "postal_code": "193652100",
            "telephone_number": "866-871-0851",
            "fax_number": "610-857-6638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LANCASTER GENERAL MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-03",
        "last_updated": "2019-11-06",
        "status": "A",
        "authorized_official_last_name": "KENNEDY",
        "authorized_official_first_name": "DENISE",
        "authorized_official_title_or_position": "VICE PRESIDENT FINANCIAL SERVICES",
        "authorized_official_telephone_number": "717-544-5010"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Penn Medicine LGHP Podiatry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Parkesburg, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2019; 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.