Wellspan Medical Group
Organization Active NPI Internal Medicine Physician · Chambersburg, PA
NPI 1386429702 · NPPES record last updated Aug 25, 2023
Key facts
- NPI
- 1386429702
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Internal Medicine Physician 207R00000X
- Legal business name
- WELLSPAN MEDICAL GROUP
- Practice address
- 761 5TH Ave Ste a
Chambersburg, PA 17201-4210 - Phone
- (717) 261-2583
- Fax
- (717) 261-2584
- NPI assigned
- Aug 25, 2023
- Organization subpart
- No
Authorized official
- Name
- Laura Frank
- Title
- Credentialing Manager
- Phone
- (717) 851-6832
Corporate family (same tax ID) 24
Practitioners 17
-
Jessica Ahlum, MD
-
Stephen K Baker, MD
-
Jennifer A. Bishop, C.R.N.P.
-
Stephanie Church, CRNP
-
Michele Deiterich, CRNA
-
Nidhi Garg, MD
-
Amanda Lynn Lawson, CRNP
-
Pradipta Majumder, M.D.
-
Angela Sue March, CRNP
-
James L Rossi, PMHNP-BC
-
Jamie Stiffler, CRNP
-
Becky Hollibaugh, DO
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
- Tax ID family
- Linda M Miller
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician |
207R00000X | Yes |
Addresses
Primary practice location
761 5TH Ave Ste a
Chambersburg, PA 17201-4210
Mailing address
601 Memory LN
York, PA 17402-2231
Phone (717) 851-1405
Other practice location 1
130 E Main St
Fayetteville, PA 17222-9503
Phone (717) 352-7881
Other names
- WellSpan Internal Medicine - Park 5th Ave
Other providers in Chambersburg, PA
- Wellspan Medical Group
- Wellspan Medical Group
- Wellspan Medical Group
- Wellspan Medical Group
- Wellspan Medical Group
- Wellspan Medical Group
- Wellspan Medical Group
- Wellspan Medical Group
- Wellspan Medical Group
- Wellspan Medical Group
All providers in Chambersburg, PA · Internal Medicine Physician in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 25, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.