Wellspan Medical Group

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

WELLSPAN MEDICAL GROUP

Practice address

1635 W Main St Ste 700
Ephrata, PA 17522-1147

Phone

(717) 738-2468

NPI assigned

Dec 8, 2021

Organization subpart

No

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

Addresses

Other names 1

• WellSpan Family Medicine-W Main St Doing business as

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 21

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jonathan Adzema

  • Certified Registered Nurse Anesthetist
  • York, PA
  • NPI 1871146969
  NPD
• Brad J Conner, DO

  • Orthopaedic Surgery Physician
  • Chambersburg, PA
  • NPI 1225357668
  NPD
• Caren C Goldberg, CRNP

  • Nurse Practitioner
  • Lebanon, PA
  • NPI 1326402793
  NPD
• David Gordon Kann, MD

  • Cardiovascular Disease Physician
  • Carlisle, PA
  • NPI 1154328961
  NPD
• Jamie Knarr, C.R.N.P.

  • Family Nurse Practitioner
  • Ephrata, PA
  • NPI 1710937768
  NPD
• Tobias Charles Long, M.D.

  • Plastic and Reconstructive Surgery Physician
  • Lancaster, PA
  • NPI 1427314939

  Single Specialty

  NPD
• Rajesh Makkenchery, MD

  • Surgery Physician
  • Gettysburg, PA
  • NPI 1104885748
  NPD
• Rachel Benelli Markey

  • Family Medicine Physician
  • East Berlin, PA
  • NPI 1578895017
  NPD
• Jenna L Martin, FNP

  • Family Nurse Practitioner
  • Exton, PA
  • NPI 1053860015

  Single Specialty

  NPD
• John P McNamara, DO

  • Cardiovascular Disease Physician
  • Burnham, PA
  • NPI 1760460596
  NPD
• Emily N Miller, PA-C

  • Medical Physician Assistant
  • York, PA
  • NPI 1700155280
  NPD
• Elena Yurievna Nebrat

  • Acute Care Nurse Practitioner
  • Harrisburg, PA
  • NPI 1003135781
  NPD

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"
        }
    ]
}

• Wellspan Endoscopy Center LLC
• Wellspan Medical Group
• Wellspan Medical Group
• Wellspan Medical Group
• Wellspan Medical Group
• Wellspan Medical Group
• Wellspan Medical Group
• Wellspan Medical Group
• Wellspan Medical Group
• Wellspan Medical Group

• Family Medicine Physician in Ephrata, PA
• Providers in Ephrata, 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 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.

Verify at the official NPI Registry.