Organization Active NPI

Pinnacle Health Medical Services

Doing business as Shepherdstown Family Practice

  • Family Medicine Physician
  • Mechanicsburg, PA
National Provider Identifier
1164860888
Registry record updated Nov 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
PINNACLE HEALTH MEDICAL SERVICES
Doing business as
Shepherdstown Family Practice
Practice address
2140 Fisher Rd
Mechanicsburg, PA 17055-5122
Phone
(717) 766-1795
Fax
(717) 697-6575
NPI assigned
Jun 5, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2016

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

Authorized official

Name
Mr. Christopher P Markley
Title
Senior VP
Phone
(717) 231-8210

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X

Addresses

Primary practice location

2140 Fisher Rd
Mechanicsburg, PA 17055-5122

Mailing address

409 S 2ND St
Suite 2F
Harrisburg, PA 17104-1612

Other identifiers 1

IdentifierTypeStateIssuer
1007666760 0064MedicaidPA

Other names 1

  • Shepherdstown Family Practice Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040407000180 PA Part B Supplier - Clinic/Group Practice 7618960493 Receives reassigned benefits from 2,171 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1370390400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1478131200000",
    "number": "1164860888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 S 2ND ST",
            "address_2": "SUITE 2F",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171041612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2140 FISHER RD",
            "city": "MECHANICSBURG",
            "state": "PA",
            "postal_code": "170555122",
            "telephone_number": "717-766-1795",
            "fax_number": "717-697-6575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINNACLE HEALTH MEDICAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-05",
        "last_updated": "2016-11-03",
        "status": "A",
        "authorized_official_last_name": "MARKLEY",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "SENIOR VP",
        "authorized_official_telephone_number": "717-231-8210",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007666760 0064",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shepherdstown Family Practice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mechanicsburg, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2016; 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.