Organization Active NPI

Wellspan Medical Group

Doing business as WellSpan Family Medicine - Suite 203

  • Family Medicine Physician
  • Chambersburg, PA
National Provider Identifier
1386350866
Registry record updated May 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
WELLSPAN MEDICAL GROUP
Doing business as
WellSpan Family Medicine - Suite 203
Practice address
12 St Paul Dr Ste 203
Chambersburg, PA 17201-1035
Phone
(717) 264-6511
Fax
(717) 264-1081
NPI assigned
Jan 27, 2023
Last updated
May 7, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 7, 2024

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

Authorized official

Name
Jennifer Sweitzer
Title
Director & Ao
Phone
(717) 851-6838

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

12 St Paul Dr Ste 203
Chambersburg, PA 17201-1035

Mailing address

601 Memory LN
York, PA 17402-2231
Phone (717) 851-1405

Other names 1

  • WellSpan Family Medicine - Suite 203 Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040220000815 PA Part B Supplier - Clinic/Group Practice 1951213115 Receives reassigned benefits from 3,390 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory

Locations

25 Monument Rd
Ste 140
York, PA 17403
Phone (717) 741-8003

Practitioners & affiliated clinicians

Practitioners 18

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.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1674777600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715040000000",
    "number": "1386350866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 MEMORY LN",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174022231",
            "telephone_number": "717-851-1405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 ST PAUL DR STE 203",
            "city": "CHAMBERSBURG",
            "state": "PA",
            "postal_code": "172011035",
            "telephone_number": "717-264-6511",
            "fax_number": "717-264-1081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLSPAN MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-27",
        "last_updated": "2024-05-07",
        "certification_date": "2024-05-07",
        "status": "A",
        "authorized_official_last_name": "SWEITZER",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "DIRECTOR & AO",
        "authorized_official_telephone_number": "717-851-6838"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WellSpan Family Medicine - Suite 203",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "WellSpan Family Medicine - Suite 203",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chambersburg, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.