Family Medicine at Spring Grove LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD424789 Issued in PA

Legal business name

FAMILY MEDICINE AT SPRING GROVE LLC

Practice address

24 Roth's Church Road
Spring Grove, PA 17362

Phone

(717) 739-8174

Fax

(717) 739-8180

NPI assigned

Jul 30, 2008

Last updated

Mar 24, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Nancy Ann Faulkner, MD

Title

Physician, Owner of Business/LLC

Phone

(717) 739-8174

Specialties & licenses 1

Addresses

Other names 1

• Nancy A. Faulkner MD Other name

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

{
    "created_epoch": "1217376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1237852800000",
    "number": "1164688131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 ROTH'S CHURCH ROAD",
            "city": "SPRING GROVE",
            "state": "PA",
            "postal_code": "17362",
            "telephone_number": "717-739-8174",
            "fax_number": "717-739-8180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 ROTH'S CHURCH ROAD",
            "city": "SPRING GROVE",
            "state": "PA",
            "postal_code": "17362",
            "telephone_number": "717-739-8174",
            "fax_number": "717-739-8180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY MEDICINE AT SPRING GROVE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-30",
        "last_updated": "2009-03-24",
        "status": "A",
        "authorized_official_last_name": "FAULKNER",
        "authorized_official_first_name": "NANCY",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "PHYSICIAN, OWNER OF BUSINESS/LLC",
        "authorized_official_telephone_number": "717-739-8174",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD424789",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Nancy A. Faulkner MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Family Medicine Physician in Spring Grove, PA
• Providers in Spring Grove, PA by specialty
• Family Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 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.