Active NPI
Memorial Enterprises Inc
- Family Medicine Physician
- York, PA
National Provider Identifier
1184765836
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- OS012217L
- Legal business name
- MEMORIAL ENTERPRISES INC
- Doing business as
- Memorial Primary Care Network
- Practice address
- 2295A N Susquehanna TRL
York, PA 17404-8495 - Phone
- (717) 812-0731
- Fax
- (717) 812-9848
- NPI assigned
- Feb 8, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ms. Linda A Neubauer, CPC
- Title
- MGR of Finance and Coding
- Phone
- (717) 815-2557
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | OS012217L | PA | Primary |
| Family Medicine Physician | 207Q00000X | OS010092L | PA | |
| Family Medicine Physician | 207Q00000X | OS009643L | PA |
Addresses
Primary practice location
2295A N Susquehanna TRL
York, PA 17404-8495
Mailing address
1420 6TH Ave
Suite 4
York, PA 17403-2620
Phone (717) 815-2557
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01960399 | Medicaid | PA | |
| 01807995 | Medicaid | PA | |
| 001867044 | Medicaid | PA |
Other names 1
- Memorial Primary Care Network
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170892800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1211155200000",
"number": "1184765836",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1420 6TH AVE",
"address_2": "SUITE 4",
"city": "YORK",
"state": "PA",
"postal_code": "174032620",
"telephone_number": "717-815-2557",
"fax_number": "717-854-1434"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2295A N SUSQUEHANNA TRL",
"city": "YORK",
"state": "PA",
"postal_code": "174048495",
"telephone_number": "717-812-0731",
"fax_number": "717-812-9848"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MEMORIAL ENTERPRISES INC",
"organizational_subpart": "NO",
"enumeration_date": "2007-02-08",
"last_updated": "2008-05-19",
"status": "A",
"authorized_official_last_name": "NEUBAUER",
"authorized_official_first_name": "LINDA",
"authorized_official_middle_name": "A",
"authorized_official_title_or_position": "MGR OF FINANCE AND CODING",
"authorized_official_telephone_number": "717-815-2557",
"authorized_official_name_prefix": "Ms.",
"authorized_official_credential": "CPC"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Family Medicine",
"state": "PA",
"license": "OS012217L",
"primary": true
},
{
"code": "207Q00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Family Medicine",
"state": "PA",
"license": "OS010092L",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Family Medicine",
"state": "PA",
"license": "OS009643L",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01960399",
"state": "PA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01807995",
"state": "PA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "001867044",
"state": "PA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Memorial Primary Care Network",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in York, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.