Central Pennsylvania Pulmonary Associates LLC

Primary specialty

Pulmonary Disease PhysicianTaxonomy code 207RP1001X

Legal business name

CENTRAL PENNSYLVANIA PULMONARY ASSOCIATES LLC

Practice address

2250 Millenium Way
Ste 400
Enola, PA 17025-1488

Phone

(717) 724-2791

Fax

(717) 724-2797

NPI assigned

May 2, 2006

Last updated

Nov 7, 2007By 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

Timothy A Clark, MDNPI 1407814726

Title

President Ceo

Phone

(717) 724-2791

Specialties & licenses 2

Addresses

Other identifiers 8

Locations

Practitioners 5

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.

• Timothy A Clark, MD

  • Pulmonary Disease Physician
  • Enola, PA
  • NPI 1407814726
  NPD Authorized official
• William Trevor Broadbent, PA-C

  • Medical Physician Assistant
  • Hershey, PA
  • NPI 1447255781
  NPD (past)
• Ricardo Calla, PA

  • Physician Assistant
  • Mechanicsburg, PA
  • NPI 1306804620
  NPD (past)
• Daniel S Watkins, PA

  • Trauma Surgery Physician
  • Hershey, PA
  • NPI 1134308687
  NPD (past)
• George Kevork Shahinian, M.D.

  • Pulmonary Disease Physician
  • Aliso Viejo, CA
  • NPI 1487611372
  NPD (past)

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

{
    "created_epoch": "1146528000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194393600000",
    "number": "1356309223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2250 MILLENIUM WAY",
            "address_2": "SUITE 400",
            "city": "ENOLA",
            "state": "PA",
            "postal_code": "170251488",
            "telephone_number": "717-724-2791",
            "fax_number": "717-724-2797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2250 MILLENIUM WAY",
            "address_2": "STE 400",
            "city": "ENOLA",
            "state": "PA",
            "postal_code": "170251488",
            "telephone_number": "717-724-2791",
            "fax_number": "717-724-2797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL PENNSYLVANIA PULMONARY ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-02",
        "last_updated": "2007-11-07",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT CEO",
        "authorized_official_telephone_number": "717-724-2791",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GATEWAY",
            "identifier": "1547028",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPITAL BLUE CROSS",
            "identifier": "02753200",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO",
            "identifier": "3841362",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH MERCY",
            "identifier": "20042172",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001957188 0002",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA NON HMO",
            "identifier": "7578487",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK",
            "identifier": "1485178",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PERSONAL CHOICE PPO",
            "identifier": "2176430000",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Leanne Broadbent, M.S., CCC-SLP
• Bradley James Brockbank, PA-C
• Earla C Bucher, NNP
• Capital Area Intermediate Unit
• Vicki Jo Carrier, BSN,MSN,CRNFA,ARNP
• Mark G Cherewka, DMD
• Christensen Chiropractic
• Barbara Christensen, DC
• Thomas Chu, D.O.
• Daniel J Church, PA-C

• Pulmonary Disease Physician in Enola, PA
• Providers in Enola, PA by specialty
• Pulmonary Disease Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.