Active NPI
Wellspan Medical Group
Doing business as WellSpan Family Medicine-W Main St
- Family Medicine Physician
- Ephrata, PA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- Legal business name
- WELLSPAN MEDICAL GROUP
- Doing business as
- WellSpan Family Medicine-W Main St
- Practice address
- 1635 W Main St Ste 700
Ephrata, PA 17522-1147 - Phone
- (717) 738-2468
- NPI assigned
- Dec 8, 2021
- Last updated
- Dec 8, 2021
- 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
- Laura Frank
- Title
- Credentialing Manager
- Phone
- (717) 851-6832
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | Primary |
Addresses
Primary practice location
1635 W Main St Ste 700
Ephrata, PA 17522-1147
Mailing address
3421 Concord Rd
York, PA 17402-9001
Phone (717) 851-1405
Other names 1
- WellSpan Family Medicine-W Main St
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040220000815 | PA | Part B Supplier - Clinic/Group Practice | 1951213115 |
Receives reassigned benefits from 3,390 practitioners This NPI is an additional NPI on the enrollment |
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 39D0188058 | Wellspan Family Medicine W Main Street | Certificate of waiver | Apr 1, 2027 |
National Provider Directory
National Provider DirectoryLocations
450 S Washington St
Ste A
Gettysburg, PA 17325
Phone (717) 339-3105
450 S Washington St
Ste C
Gettysburg, PA 17325
Phone (717) 334-8141
Practitioners & affiliated clinicians
Practitioners 21
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.
-
- Certified Registered Nurse Anesthetist
- York, PA
- NPI 1871146969
-
- Orthopaedic Surgery Physician
- Chambersburg, PA
- NPI 1225357668
-
- Nurse Practitioner
- Lebanon, PA
- NPI 1326402793
-
- Cardiovascular Disease Physician
- Carlisle, PA
- NPI 1154328961
-
- Family Nurse Practitioner
- Ephrata, PA
- NPI 1710937768
-
- Plastic and Reconstructive Surgery Physician
- Lancaster, PA
- NPI 1427314939
Single Specialty
-
- Surgery Physician
- Gettysburg, PA
- NPI 1104885748
-
- Family Medicine Physician
- East Berlin, PA
- NPI 1578895017
-
- Cardiovascular Disease Physician
- Burnham, PA
- NPI 1760460596
-
- Medical Physician Assistant
- York, PA
- NPI 1700155280
-
- Acute Care Nurse Practitioner
- Harrisburg, PA
- NPI 1003135781
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1638921600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1638921600000",
"number": "1194484089",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3421 CONCORD RD",
"city": "YORK",
"state": "PA",
"postal_code": "174029001",
"telephone_number": "717-851-1405",
"fax_number": "717-851-6969"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1635 W MAIN ST STE 700",
"city": "EPHRATA",
"state": "PA",
"postal_code": "175221147",
"telephone_number": "717-738-2468"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "WELLSPAN MEDICAL GROUP",
"organizational_subpart": "NO",
"enumeration_date": "2021-12-08",
"last_updated": "2021-12-08",
"certification_date": "2021-12-01",
"status": "A",
"authorized_official_last_name": "FRANK",
"authorized_official_first_name": "LAURA",
"authorized_official_title_or_position": "CREDENTIALING MANAGER",
"authorized_official_telephone_number": "717-851-6832"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Family Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "WellSpan Family Medicine-W Main St",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Ephrata, PA
- Wellspan Endoscopy Center LLC (WellSpan Endoscopy Center at Barrett Boulevard)
- Wellspan Medical Group (Wellspan Health Beginnings Plus-ECH)
- Wellspan Medical Group (WellSpan Breast Surgery)
- Wellspan Medical Group (WellSpan Radiology and Radiation Oncology)
- Wellspan Medical Group (WellSpan Family Medicine - Trout Run)
- Wellspan Medical Group (WellSpan Family Medicine)
- Wellspan Medical Group (WellSpan Diagnostic Support Specialists)
- Wellspan Medical Group (WellSpan Urgent Care)
- Wellspan Medical Group (WellSpan Maternal Fetal Medicine)
- Wellspan Medical Group (WellSpan Internal Medicine - Ephrata)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.