Lancaster General Medical Group

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

LANCASTER GENERAL MEDICAL GROUP

Practice address

222 Willow Valley Lakes Dr
Suite 1900
Willow Street, PA 17584-9670

Phone

(717) 517-5350

Fax

(717) 517-5351

NPI assigned

Jan 6, 2015

Organization subpart

No

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

Authorized official

Name

Denise Kennedy

Title

Vice President Financial Services

Phone

(717) 544-5010

Specialties & licenses 1

Addresses

Other names 1

• Penn Medicine LGHP Family Medicine Willow Street Doing business as

Electronic endpoints 1

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 12

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

• Lynne Amy Booth, M.D

  • Family Medicine Physician
  • Lancaster, PA
  • NPI 1720480858
  NPD
• Rienna P Fulmer, PA-C

  • Physician Assistant
  • Lancaster, PA
  • NPI 1245428879
  NPD
• Nichole Gehman, CRNP

  • Nurse Practitioner
  • Gap, PA
  • NPI 1174992515
  NPD
• Marina Gonzalez, MD

  • Family Medicine Physician
  • Willow Street, PA
  • NPI 1487148565
  NPD
• Amber Leed

  • Family Nurse Practitioner
  • Ephrata, PA
  • NPI 1912355884
  NPD
• Catherine Lynn Main, M.D.

  • Family Medicine Physician
  • Lancaster, PA
  • NPI 1356600373
  NPD
• Michael David Seiferth, MD

  • Family Medicine Physician
  • Willow Street, PA
  • NPI 1104406107
  NPD
• Oliver S. Wagner, M.D.

  • Family Medicine Physician
  • Lancaster, PA
  • NPI 1588001713
  NPD
• David Scott Warsaw, D.O.

  • Plastic Surgery Physician
  • Lancaster, PA
  • NPI 1386641314
  NPD
• John C. Wood, M.D.

  • Family Medicine Physician
  • Lancaster, PA
  • NPI 1528124971
  NPD
• Michael S. Flood, M.D.

  • Plastic Surgery Physician
  • Lancaster, PA
  • NPI 1346247715
  NPD (past)
• Michelle Nguyen, CRNP

  • Nurse Practitioner
  • Lancaster, PA
  • NPI 1982256855
  NPD (past)

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

{
    "created_epoch": "1420502400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1605484800000",
    "number": "1326436882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 WILLOW VALLEY LAKES DR",
            "address_2": "SUITE 1900",
            "city": "WILLOW STREET",
            "state": "PA",
            "postal_code": "175849670",
            "telephone_number": "717-517-5350",
            "fax_number": "717-517-5351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 WILLOW VALLEY LAKES DR",
            "address_2": "SUITE 1900",
            "city": "WILLOW STREET",
            "state": "PA",
            "postal_code": "175849670",
            "telephone_number": "717-517-5350",
            "fax_number": "717-517-5351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LANCASTER GENERAL MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-06",
        "last_updated": "2020-11-16",
        "certification_date": "2020-11-16",
        "status": "A",
        "authorized_official_last_name": "KENNEDY",
        "authorized_official_first_name": "DENISE",
        "authorized_official_title_or_position": "VICE PRESIDENT FINANCIAL SERVICES",
        "authorized_official_telephone_number": "717-544-5010"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1068.1",
            "affiliationName": "Cobius Healthcare Solutions",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "2720 Dundee Rd # 302",
            "city": "Northbrook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600622609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Penn Medicine LGHP Family Medicine Willow Street",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Keri Lynn Kury, RN
• Sarah Jane Kury
• Lancaster Co Career & Technology Ctr
• Lancaster Family Medicine Associates, P.C.
• Lancaster General Hospital
• Lancaster Urological Group, Inc.
• Kathryn Anne Landis, MSW LSW
• Alexis H Le
• Lebanon Vamc
• Life Span Psychological Services PC

• Family Medicine Physician in Willow Street, PA
• Providers in Willow Street, 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 Nov 16, 2020; 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.