Penn State Health Life Lion, LLC

Primary specialty

AmbulanceTaxonomy code 341600000X

Legal business name

PENN STATE HEALTH LIFE LION, LLC

Practice address

431 N 21St St Ste 101
Camp Hill, PA 17011-2202

Phone

(717) 763-2108

Fax

(717) 972-4753

NPI assigned

Aug 25, 2020

Last updated

Jan 25, 2021By the provider in NPPES

Organization subpart

Yes

Parent organization

PENN STATE HEALTHAs reported in NPPES

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

Authorized official

Name

Stephen M Massini

Title

Chief Executive Officer

Phone

(717) 531-6614

Specialties & licenses 2

Addresses

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

Part of

Penn State Health

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• The Pennsylvania State University

  dba Psychological Clinic

  • Public Health or Welfare Agency
  • University Park, PA
  • NPI 1386784593

  Member Of

  NPD member

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Penn State Health

  • Registered Nurse
  • Enola, PA
  • NPI 1497627566
  NPPES parent name

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

{
    "created_epoch": "1598313600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611532800000",
    "number": "1295348761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 UNIVERSITY DRIVE",
            "address_2": "MAIL CODE CA210",
            "city": "HERSHEY",
            "state": "PA",
            "postal_code": "17033",
            "telephone_number": "717-531-1159",
            "fax_number": "717-531-0119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "431 N 21ST ST STE 101",
            "city": "CAMP HILL",
            "state": "PA",
            "postal_code": "170112202",
            "telephone_number": "717-763-2108",
            "fax_number": "717-972-4753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENN STATE HEALTH LIFE LION, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PENN STATE HEALTH",
        "enumeration_date": "2020-08-25",
        "last_updated": "2021-01-25",
        "certification_date": "2021-01-25",
        "status": "A",
        "authorized_official_last_name": "MASSINI",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "717-531-6614"
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Penn Foot and Ankle Care Center
• Penn State Health Holy Spirit Medical Center
• Penn State Health Holy Spirit Medical Center
• Penn State Health Holy Spirit Medical Center
• Penn State Health Holy Spirit Medical Center
• Penn State Health Medical Group, LLC
• Penn State Health Medical Group, LLC
• Penn State Health Medical Group, LLC
• Penn State Health Medical Group, LLC
• Penn State Health Medical Group, LLC

• Ambulance in Camp Hill, PA
• Providers in Camp Hill, PA by specialty
• Ambulance in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 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.