Northern Lancaster County Medical Group

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD032838L Issued in PA

Legal business name

NORTHERN LANCASTER COUNTY MEDICAL GROUP

Doing business as

Wellspan Family Medicine-Granite Run

Practice address

264 Granite Run Dr
Lancaster, PA 17601-6804

Phone

(717) 721-8205

Fax

(717) 721-8251

NPI assigned

Jul 14, 2008

Organization subpart

No

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

Authorized official

Name

Charles David Noll, DO

Title

Vice President

Phone

(717) 859-5161

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Wellspan Family Medicine-Granite Run Doing business as

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

{
    "created_epoch": "1215993600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1444867200000",
    "number": "1184888778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "264 GRANITE RUN DR",
            "city": "LANCASTER",
            "state": "PA",
            "postal_code": "176016804",
            "telephone_number": "717-721-8205",
            "fax_number": "717-721-8251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "264 GRANITE RUN DR",
            "city": "LANCASTER",
            "state": "PA",
            "postal_code": "176016804",
            "telephone_number": "717-721-8205",
            "fax_number": "717-721-8251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHERN LANCASTER COUNTY MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-14",
        "last_updated": "2015-10-15",
        "status": "A",
        "authorized_official_last_name": "NOLL",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "717-859-5161",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD032838L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1013977730021",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wellspan Family Medicine-Granite Run",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Emily Ann Norris, PA-C
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• Family Medicine Physician in Lancaster, PA
• Providers in Lancaster, 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 Oct 15, 2015; 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.