NPIMap

Organization Active NPI

Lung Sleep and Critical Care Consultants, PC

  • Pulmonary Disease Physician
  • York, PA
National Provider Identifier
1083607352
Registry record updated Apr 20, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
MD051542L Issued in PA
Legal business name
LUNG SLEEP AND CRITICAL CARE CONSULTANTS, PC
Practice address
2350 Freedom Way
Suite 200
York, PA 17402-8200
Phone
(717) 851-2465
Fax
(717) 741-3043
NPI assigned
Aug 23, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2009

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

Authorized official

Name
T Glen Bouder, MDNPI 1043203318
Title
Director/Active,Attending
Phone
(747) 851-6151

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RP1001X MD051542L PA Primary

Addresses

Primary practice location

2350 Freedom Way
Suite 200
York, PA 17402-8200

Mailing address

2350 Freedom Way
Suite 200
York, PA 17402-8200
Phone (717) 851-2465

Other identifiers 2

IdentifierTypeStateIssuer
1014367640001OtherPA25 MONUMENT RD #/DEACTIVATED AS OF 10/2008
1014367640005MedicaidPA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1124755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1240185600000",
    "number": "1083607352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2350 FREEDOM WAY",
            "address_2": "SUITE 200",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174028200",
            "telephone_number": "717-851-2465",
            "fax_number": "717-741-3043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2350 FREEDOM WAY",
            "address_2": "SUITE 200",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174028200",
            "telephone_number": "717-851-2465",
            "fax_number": "717-741-3043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUNG SLEEP AND CRITICAL CARE CONSULTANTS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-23",
        "last_updated": "2009-04-20",
        "status": "A",
        "authorized_official_last_name": "BOUDER",
        "authorized_official_first_name": "T",
        "authorized_official_middle_name": "GLEN",
        "authorized_official_title_or_position": "DIRECTOR/ACTIVE,ATTENDING",
        "authorized_official_telephone_number": "747-851-6151",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "PA",
            "license": "MD051542L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "25 MONUMENT RD #/DEACTIVATED AS OF 10/2008",
            "identifier": "1014367640001",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1014367640005",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in York, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.