Wellspan Medical Group

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

WELLSPAN MEDICAL GROUP

Doing business as

Wellspan Family Medicine - Herr's Ridge

Practice address

820 Chambersburg Rd
Gettysburg, PA 17325-3310

Phone

(717) 337-4410

Fax

(717) 337-4411

NPI assigned

Dec 1, 2006

Last updated

Jan 11, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Christina Vest

Title

Credentialing Supervisor

Phone

(717) 851-1405

Specialties & licenses 1

Addresses

Other identifiers 13

Other names 1

• WELLSPAN FAMILY MEDICINE - HERR'S RIDGE 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, and the practitioner matching its NPPES authorized official.

• Amy Jill Brickner, CRNP

  • Pediatric Nurse Practitioner
  • York, PA
  • NPI 1740549427
  NPD
• Monica Cristina Del Moral-Suazo

  • Obstetrics & Gynecology Physician
  • York, PA
  • NPI 1790249399
  NPD
• Raymond Karl Gilmore Jr., CRNA

  • Certified Registered Nurse Anesthetist
  • York, PA
  • NPI 1285705897
  NPD
• Daniel Scott Henriksen, MD

  • Surgery Physician
  • York, PA
  • NPI 1982619276
  NPD
• Dennis E Johnson, MD

  • Surgical Oncology Physician
  • York, PA
  • NPI 1164429353
  NPD
• John Francis Keenan, M.D.

  • Hospitalist Physician
  • York, PA
  • NPI 1790084366

  Family Medicine

  NPD
• Dhruv Mahtta, DO, MBA

  • Interventional Cardiology Physician
  • York, PA
  • NPI 1396108049
  NPD
• Joseph M Mucciolo Jr., MD

  • Surgery Physician
  • Lewisburg, PA
  • NPI 1447228366
  NPD
• Bryan George Pilkington, M.D.

  • Surgery Physician
  • Lebanon, PA
  • NPI 1366536344
  NPD
• Sunita Goyle Ray, MD

  • Nephrology Physician
  • York, PA
  • NPI 1922050079
  NPD
• Ben Z Roitberg, MD

  • Neurological Surgery Physician
  • Lebanon, PA
  • NPI 1013929694
  NPD
• Darshan S Shah, MD

  • Orthopaedic Surgery Physician
  • Lancaster, PA
  • NPI 1710347588
  NPD

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

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1515628800000",
    "number": "1275601676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1803 MOUNT ROSE AVE",
            "address_2": "SUITE B3",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174033051",
            "telephone_number": "717-851-1405",
            "fax_number": "717-337-4411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 CHAMBERSBURG RD",
            "city": "GETTYSBURG",
            "state": "PA",
            "postal_code": "173253310",
            "telephone_number": "717-337-4410",
            "fax_number": "717-337-4411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLSPAN MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-01",
        "last_updated": "2018-01-11",
        "status": "A",
        "authorized_official_last_name": "VEST",
        "authorized_official_first_name": "CHRISTINA",
        "authorized_official_title_or_position": "CREDENTIALING SUPERVISOR",
        "authorized_official_telephone_number": "717-851-1405",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CA3246",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JOHN HOPKINS",
            "identifier": "800174",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "1382344",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST MD BCBS",
            "identifier": "KX10",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GATEWAY",
            "identifier": "1520445",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH 65 PA",
            "identifier": "0404995001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNISON",
            "identifier": "130452",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7865863",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MD MEDICAL ASSISTANCE",
            "identifier": "401065502",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007721360127",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH MERCY",
            "identifier": "20013070",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPITAL BLUE CROSS",
            "identifier": "03273300",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GEISINGER",
            "identifier": "S1FB",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WELLSPAN FAMILY MEDICINE - HERR'S RIDGE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Raymond Butler Weiss, M.D.
• Wellness From Within Chiropractic LLC
• Wellspan Medical Group (WellSpan Neonatology)
• Wellspan Medical Group (Adams County Internal Medicine)
• Wellspan Medical Group (WellSpan Internal Medicine - V Twin Dr)
• Wellspan Medical Group (WellSpan Internal Medicine-Washington Street)
• Wellspan Medical Group (Gettysburg Health Center by WellSpan)
• Wellspan Medical Group (WellSpan Urgent Care)
• Wellspan Medical Group (WellSpan Pulmonary and Sleep Medicine)
• Wellspan Medical Group (Adams County Women's Health)

• Family Medicine Physician in Gettysburg, PA
• Providers in Gettysburg, 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 Jan 11, 2018; 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.