NPIMap

Organization Active NPI

Lancaster General Medical Group

Doing business as Penn Medicine LGHP Urgent Care Lebanon

  • Urgent Care Clinic/Center
  • Lebanon, PA
National Provider Identifier
1124402474
Registry record updated Nov 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
LANCASTER GENERAL MEDICAL GROUP
Doing business as
Penn Medicine LGHP Urgent Care Lebanon
Practice address
1701 Cornwall Rd Ste 101
Lebanon, PA 17042-7480
Phone
(717) 675-1788
Fax
(717) 675-1800
NPI assigned
Jul 16, 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 Kennedy
Title
Vice President Financial Services
Phone
(717) 544-5010

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X NU Primary
Family Medicine Physician 207Q00000X NU

Addresses

Primary practice location

1701 Cornwall Rd Ste 101
Lebanon, PA 17042-7480

Mailing address

1701 Cornwall Rd Ste 101
Lebanon, PA 17042-7480
Phone (717) 675-1788

Other names 1

  • Penn Medicine LGHP Urgent Care Lebanon 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 PA2 enrollments

Enrollment records 2

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
O20190117003821 PA DME Supplier - Physician - General Practice 0941103683 Practice locations: Lebanon, PA

Other NPIs with the same Medicare PAC ID 7

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

National Provider Directory

National Provider Directory

Locations

802 New Holland Ave
Ste 100
Lancaster, PA 17602
Phone (717) 544-1427

1701 Cornwall Rd
Ste 101
Lebanon, PA 17042
Phone (717) 544-9400

Practitioners & affiliated clinicians

Practitioners 18

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 18

NPI Registry JSON

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

{
    "created_epoch": "1437004800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1605484800000",
    "number": "1124402474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 CORNWALL RD STE 101",
            "city": "LEBANON",
            "state": "PA",
            "postal_code": "170427480",
            "telephone_number": "717-675-1788",
            "fax_number": "717-675-1800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 CORNWALL RD STE 101",
            "city": "LEBANON",
            "state": "PA",
            "postal_code": "170427480",
            "telephone_number": "717-675-1788",
            "fax_number": "717-675-1800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LANCASTER GENERAL MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-16",
        "last_updated": "2020-11-16",
        "certification_date": "2020-11-16",
        "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": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "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 Urgent Care Lebanon",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lebanon, 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.