Active NPI
Lebanon Valley Family Medicine, Inc
- Family Medicine Physician
- Palmyra, PA
National Provider Identifier
1386609014
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- Legal business name
- LEBANON VALLEY FAMILY MEDICINE, INC
- Practice address
- 1400 S Forge Rd
Palmyra, PA 17078-9519 - Phone
- (717) 838-1301
- NPI assigned
- Apr 18, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Shirley L Dailey
- Title
- Business Manager
- Phone
- (717) 838-1301
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | Primary |
Addresses
Primary practice location
1400 S Forge Rd
Palmyra, PA 17078-9519
Mailing address
1400 S Forge Rd
Palmyra, PA 17078-9519
Phone (717) 838-1301
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040306000058 | PA | Part B Supplier - Clinic/Group Practice | 7214825876 |
Receives reassigned benefits from 9 practitioners Practice locations: Annville, PA; Palmyra, PA |
National Provider Directory
National Provider DirectoryLocations
10484 Jonestown Rd
Annville, PA 17003
Phone (717) 865-0324
1400 S Forge Rd
Ste 1
Palmyra, PA 17078
Phone (717) 838-1301
Practitioners & affiliated clinicians
Practitioners 11
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Family Medicine Physician
- Palmyra, PA
- NPI 1548676364
Family Medicine, PA
-
- Physician Assistant
- Palmyra, PA
- NPI 1245158120
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1145318400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1386609014",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1400 S FORGE RD",
"city": "PALMYRA",
"state": "PA",
"postal_code": "170789519",
"telephone_number": "717-838-1301"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1400 S FORGE RD",
"city": "PALMYRA",
"state": "PA",
"postal_code": "170789519",
"telephone_number": "717-838-1301"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LEBANON VALLEY FAMILY MEDICINE, INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-04-18",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "DAILEY",
"authorized_official_first_name": "SHIRLEY",
"authorized_official_middle_name": "L",
"authorized_official_title_or_position": "BUSINESS MANAGER",
"authorized_official_telephone_number": "717-838-1301"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Family Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Palmyra, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.