NPIMap

Organization Active NPI

Pinnacle Health Medical Services

Doing business as Colonial Park Family Practice

  • Family Medicine Physician
  • Harrisburg, PA
National Provider Identifier
1508204215
Registry record updated Jun 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
PINNACLE HEALTH MEDICAL SERVICES
Doing business as
Colonial Park Family Practice
Practice address
4807 Jonestown Rd
Suite 141
Harrisburg, PA 17109-1739
Phone
(717) 657-3030
Fax
(717) 671-0991
NPI assigned
Jun 5, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2013

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

Authorized official

Name
Mr. Christopher P Markley
Title
Senior VP
Phone
(717) 231-8210

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X

Addresses

Primary practice location

4807 Jonestown Rd
Suite 141
Harrisburg, PA 17109-1739

Mailing address

118 Washington St
Harrisburg, PA 17104-1677
Phone (717) 231-8539

Other identifiers 1

IdentifierTypeStateIssuer
1007666760 0064MedicaidPA

Other names 1

  • Colonial Park Family Practice Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040407000180 PA Part B Supplier - Clinic/Group Practice 7618960493 Receives reassigned benefits from 2,171 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory

Locations

118 Washington St
Harrisburg, PA 17104
Phone (717) 231-8539

Practitioners & affiliated clinicians

Practitioners 7

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": "1370390400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1370390400000",
    "number": "1508204215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 WASHINGTON ST",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171041677",
            "telephone_number": "717-231-8539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4807 JONESTOWN RD",
            "address_2": "SUITE 141",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171091739",
            "telephone_number": "717-657-3030",
            "fax_number": "717-671-0991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINNACLE HEALTH MEDICAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-05",
        "last_updated": "2013-06-05",
        "status": "A",
        "authorized_official_last_name": "MARKLEY",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "SENIOR VP",
        "authorized_official_telephone_number": "717-231-8210",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007666760 0064",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Colonial Park Family Practice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Harrisburg, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2013; 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.