Midatlantic Endoscopy LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

17211501 Issued in PA

Legal business name

MIDATLANTIC ENDOSCOPY LLC

Practice address

2112 Harrisburg Pike
Suite 323
Lancaster, PA 17601-2644

Phone

(717) 544-3569

NPI assigned

Mar 27, 2017

Organization subpart

No

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

Authorized official

Name

Mr. Phillip A. Clendenin

Title

President

Phone

(615) 665-1283

Specialties & licenses 1

Addresses

Other names 1

• Mid-Atlantic Gastrointestinal Center III Doing business as

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Other NPIs on the same Medicare enrollment 2

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

• Midatlantic Endoscopy LLC

  • Ambulatory Surgical Clinic/Center
  • Lancaster, PA
  • NPI 1255872784

  O20170311000032

  Same enrollment
• Midatlantic Endoscopy LLC

  • Ambulatory Surgical Clinic/Center
  • Ephrata, PA
  • NPI 1497296198

  O20170311000032

  Same enrollment

Locations

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

{
    "created_epoch": "1490572800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1505433600000",
    "number": "1124559679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2112 HARRISBURG PIKE",
            "address_2": "SUITE 323",
            "city": "LANCASTER",
            "state": "PA",
            "postal_code": "176012644",
            "telephone_number": "717-544-3569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2112 HARRISBURG PIKE",
            "address_2": "SUITE 323",
            "city": "LANCASTER",
            "state": "PA",
            "postal_code": "176012644",
            "telephone_number": "717-544-3569"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDATLANTIC ENDOSCOPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-27",
        "last_updated": "2017-09-15",
        "status": "A",
        "authorized_official_last_name": "CLENDENIN",
        "authorized_official_first_name": "PHILLIP",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "615-665-1283",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "PA",
            "license": "17211501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mid-Atlantic Gastrointestinal Center III",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mallory Michel, B.A
• Lisa Michels
• Mid Atlantic Nutrition Specialists, LLC
• Mid Atlantic Psychiatric Physicians
• Mid Atlantic Surgical Services Inc
• Midatlantic Endoscopy LLC
• Kizzy Middleton
• Middleway Wellness
• Christina Elaine Miles, MS, LPC
• Milestones Intervention

• Ambulatory Surgical Clinic/Center in Lancaster, PA
• Providers in Lancaster, PA by specialty
• Ambulatory Surgical Clinic/Center in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2017; 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.