NPIMap

Organization Active NPI

Walnut Bottom Family Practice, LLC

  • Primary Care Clinic/Center
  • Carlisle, PA
National Provider Identifier
1437455458
Registry record updated Mar 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
WALNUT BOTTOM FAMILY PRACTICE, LLC
Practice address
850 Walnut Bottom Rd
Suite 305
Carlisle, PA 17013-3632
Phone
(717) 960-0052
Fax
(717) 960-0055
NPI assigned
Feb 9, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2011

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

Authorized official

Name
Dr. Lisa C Myers, DONPI 1598742025
Title
Owner
Phone
(717) 960-0052

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

850 Walnut Bottom Rd
Suite 305
Carlisle, PA 17013-3632

Mailing address

850 Walnut Bottom Rd
Suite 305
Carlisle, PA 17013-3632
Phone (717) 960-0052

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110725000056 PA Part B Supplier - Clinic/Group Practice 0840468518 Receives reassigned benefits from 3 practitioners
Practice locations: Mount Holly Springs, PA

National Provider Directory

National Provider Directory

Locations

103 N Baltimore Ave
Mt Holly Spgs, PA 17065
Phone (717) 960-0052

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1297209600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1299542400000",
    "number": "1437455458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 WALNUT BOTTOM RD",
            "address_2": "SUITE 305",
            "city": "CARLISLE",
            "state": "PA",
            "postal_code": "170133632",
            "telephone_number": "717-960-0052",
            "fax_number": "717-960-0055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 WALNUT BOTTOM RD",
            "address_2": "SUITE 305",
            "city": "CARLISLE",
            "state": "PA",
            "postal_code": "170133632",
            "telephone_number": "717-960-0052",
            "fax_number": "717-960-0055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALNUT BOTTOM FAMILY PRACTICE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-09",
        "last_updated": "2011-03-08",
        "status": "A",
        "authorized_official_last_name": "MYERS",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "717-960-0052",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carlisle, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2011; 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.