NPIMap

Organization Active NPI

Lancaster General Hospital

  • Clinical Neuropsychologist
  • Lancaster, PA
National Provider Identifier
1114012002
Registry record updated Dec 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
Legal business name
LANCASTER GENERAL HOSPITAL
Practice address
2100 Harrisburg Pike
Lancaster, PA 17601-2644
Phone
(717) 544-3172
Fax
(717) 544-3229
NPI assigned
Oct 4, 2006
Organization subpart
Yes
Parent organization
LANCASTER GENERAL HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 17, 2025

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

Authorized official

Name
Gary A Welch
Title
Chief Operating Officer
Phone
(717) 544-5658

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical NeuropsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103G00000X Primary
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X
Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 104100000X
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X

Addresses

Primary practice location

2100 Harrisburg Pike
Lancaster, PA 17601-2644

Mailing address

2100 Harrisburg Pike
Lancaster, PA 17601-2644
Phone (717) 544-3172

Other identifiers 4

IdentifierTypeStateIssuer
5055756OtherPACAPITAL BLUE CROSS
2288603000OtherPAAMERIHEALTH 65
001365403OtherPAHIGHMARK BLUE SHIELD
10771175 0084MedicaidPA

Other names 3

  • Penn Medicine LGHP Neuropsychology Doing business as
  • Penn Medicine LGHP Neuropychology Doing business as
  • Penn Medicine Lancaster General Health Physicians Neuropychology Doing business as

Electronic endpoints 1

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

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040426000245 PA Part B Supplier - Hospital Department(S) 1254240039 Receives reassigned benefits from 12 practitioners
Practice locations: Lancaster, PA

Other NPIs with the same Medicare PAC ID 15

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 15

National Provider Directory

National Provider Directory
Tax ID family
Lancaster Gen Hosp Lab45 organizations share this tax ID, including this one
Part of
Lancaster Gen Hosp Lab

Other organizations with this tax ID 44

Organizations that report the same tax identification number in the National Provider Directory.

View all 44

Member of 1

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

Locations

2150 Harrisburg Pike
Ste 200C
Lancaster, PA 17601
Phone (717) 544-3172

Practitioners & affiliated clinicians

Practitioners 12

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": "1159920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1765929600000",
    "number": "1114012002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 HARRISBURG PIKE",
            "city": "LANCASTER",
            "state": "PA",
            "postal_code": "176012644",
            "telephone_number": "717-544-3172",
            "fax_number": "717-544-3229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 HARRISBURG PIKE",
            "city": "LANCASTER",
            "state": "PA",
            "postal_code": "176012644",
            "telephone_number": "717-544-3172",
            "fax_number": "717-544-3229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LANCASTER GENERAL HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LANCASTER GENERAL HOSPITAL",
        "enumeration_date": "2006-10-04",
        "last_updated": "2025-12-17",
        "certification_date": "2025-12-17",
        "status": "A",
        "authorized_official_last_name": "WELCH",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "717-544-5658"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPITAL BLUE CROSS",
            "identifier": "5055756",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH 65",
            "identifier": "2288603000",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "001365403",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10771175 0084",
            "state": "PA"
        }
    ],
    "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",
            "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 Neuropsychology",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Penn Medicine LGHP Neuropychology",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Penn Medicine Lancaster General Health Physicians Neuropychology",
            "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 Dec 17, 2025; 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.