NPIMap

Individual provider Active NPI

Diane M. Kepner, M.D.

  • Family Medicine Physician
  • York, PA
National Provider Identifier
1487626461
Registry record updated Dec 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD069472L Issued in PA
Practice address
80 Wyntre Brooke Dr
York, PA 17403-4535
Phone
(717) 741-9462
Fax
(717) 741-4399
NPI assigned
Feb 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD069472L PA Primary

Addresses

Primary practice location

80 Wyntre Brooke Dr
York, PA 17403-4535

Mailing address

80 Wyntre Brooke Dr
York, PA 17403-4535
Phone (717) 741-9462

Other identifiers 5

IdentifierTypeStateIssuer
02377500OtherPACAPITAL BLUE CROSS
606644OtherPAHIGHMARK BLUE SHIELD
136324OtherPAHEALTH AMERICA
0018746480001MedicaidPA
1520948OtherPAGATEWAY HEALTH PLAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220215000543 MD Practitioner - Internal Medicine 5991990723 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lifebridge Medical Associates LLCGroup PAC ID 0446470165, 18 clinicians

Practice addresses (Care Compare)

4801 Dorsey Hall Dr
Suite 201
Ellicott City, MD 21042-7749
Phone (443) 393-3788

Hospital & facility affiliations

  • Bayada Home Health Care, Inc. Home health agency, Towson, MD, CCN 217101
  • The Johns Hopkins Home Health Services, Inc Home health agency, Baltimore, MD, CCN 217081
  • Wellspan York Hospital Hospital, York, PA, CCN 390046
  • Johns Hopkins Hospital, the Hospital, Baltimore, MD, CCN 210009

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Lifebridge Medical Associates, LLC CurrentSince Mar 14, 2022 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

4801 Dorsey Hall Dr
Ste 201
Ellicott City, MD 21042
Phone (410) 997-5191

4801 Dorsey Hall Dr
#G
Ellicott City, MD 21042
Phone (443) 393-3788

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 10

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1138924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1291852800000",
    "number": "1487626461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 WYNTRE BROOKE DR",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174034535",
            "telephone_number": "717-741-9462",
            "fax_number": "717-741-4399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 WYNTRE BROOKE DR",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174034535",
            "telephone_number": "717-741-9462",
            "fax_number": "717-741-4399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEPNER",
        "first_name": "DIANE",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-03",
        "last_updated": "2010-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD069472L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPITAL BLUE CROSS",
            "identifier": "02377500",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "606644",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH AMERICA",
            "identifier": "136324",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0018746480001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GATEWAY HEALTH PLAN",
            "identifier": "1520948",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in York, PA

Sources for this page

Verify at the official NPI Registry.