Lancaster General Medical Group

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

LANCASTER GENERAL MEDICAL GROUP

Doing business as

Landisville Family Health Center

Practice address

405 Main St
Landisville, PA 17538-1812

Phone

(717) 898-2413

Fax

(717) 898-9142

NPI assigned

Nov 10, 2005

Last updated

Aug 20, 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

Dr. Jerome I Gottlieb, M.D.

Title

President

Phone

(717) 544-4001

Specialties & licenses 1

Addresses

Other identifiers 9

Other names 1

• Landisville Family Health Center Doing business as

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Locations

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

{
    "created_epoch": "1131580800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1187568000000",
    "number": "1447231923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 MAIN ST",
            "city": "LANDISVILLE",
            "state": "PA",
            "postal_code": "175381812",
            "telephone_number": "717-898-2413",
            "fax_number": "717-898-9142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 MAIN ST",
            "city": "LANDISVILLE",
            "state": "PA",
            "postal_code": "175381812",
            "telephone_number": "717-898-2413",
            "fax_number": "717-898-9142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LANCASTER GENERAL MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-10",
        "last_updated": "2007-08-20",
        "status": "A",
        "authorized_official_last_name": "GOTTLIEB",
        "authorized_official_first_name": "JEROME",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "717-544-4001",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GATEWAY HEALTH PLAN",
            "identifier": "1540390",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO",
            "identifier": "3974095",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007327490136",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPITAL BLUE CROSS",
            "identifier": "50041081",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA NON-HMO",
            "identifier": "7315670",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "1648901",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA CAP OFFICE#",
            "identifier": "676677",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GEISINGER HEALTH PLAN",
            "identifier": "S1QE",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CN7614",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Landisville Family Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• JHC Group LLC (Home Helpers and Direct Link 58661)
• James R Jiga, D.C.
• Kerry Alan Johnson, DDS
• Katherine Kauffman, PHARMD
• Samuel Joel Knapp, ED.D.
• Lancaster Sleep Solutions LLC
• Samantha Elizabeth Lansberry, MPH, RD, LDN
• John Lusaitis Sr., M.S. F.A.A.A.
• Vanessa Ivelisse Matos, DDS
• Deanna McCaskill

• Family Medicine Physician in Landisville, PA
• Providers in Landisville, PA by specialty
• Family Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2007; 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.