Lebanon Valley Family Medicine, Inc.

Primary specialty

Non-Pharmacy Dispensing SiteTaxonomy code 332900000X

License

MD027353E Issued in PA

Legal business name

LEBANON VALLEY FAMILY MEDICINE, INC.

Practice address

10484 Jonestown Rd
Annville, PA 17003-8434

Phone

(717) 865-0324

NPI assigned

Feb 25, 2008

Organization subpart

Yes

Parent organization

MEDVANTX, INC.As reported in NPPES

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

Authorized official

Name

Kenny Heine

Title

Director of Operations

Phone

(858) 625-2990

Specialties & licenses 1

Addresses

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

CLIA laboratory certificates

Tax ID family

Lebanon Valley Family Medicine Inc2 organizations share this tax ID, including this one

Part of

Tri - State Medical Group Inc

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Lebanon Valley Family Medicine Inc

  • Non-Pharmacy Dispensing Site
  • Palmyra, PA
  • NPI 1639369804
  NPD tax ID

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

{
    "created_epoch": "1203897600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1350864000000",
    "number": "1215106109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5626 OBERLIN DR",
            "address_2": "SUITE 110",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921211705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10484 JONESTOWN RD",
            "city": "ANNVILLE",
            "state": "PA",
            "postal_code": "170038434",
            "telephone_number": "717-865-0324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEBANON VALLEY FAMILY MEDICINE, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MEDVANTX, INC.",
        "enumeration_date": "2008-02-25",
        "last_updated": "2012-10-22",
        "status": "A",
        "authorized_official_last_name": "HEINE",
        "authorized_official_first_name": "KENNY",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "858-625-2990"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": "PA",
            "license": "MD027353E",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimbrough Acc Military MTF
• Leah Marie King, LPC
• Brittany Kirk, LAT, ATC
• Alex Kiviniemi
• Lebanon Valley College Physical Therapy and Sports Rehabilitation
• Joshua Cameron Leidich
• Erica A Lesniak, DMD
• Mariah Lynn Librandi
• Lightworks Psychiatric Services, Inc
• Amy Lippincott Silva, M.A.

• Non-Pharmacy Dispensing Site in Annville, PA
• Providers in Annville, PA by specialty
• Non-Pharmacy Dispensing Site in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.