Active NPI
Jean Mary LLC
- Foot & Ankle Surgery Podiatrist
- Camp Hill, PA
National Provider Identifier
1508640947
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Foot & Ankle Surgery Podiatrist
- Legal business name
- JEAN MARY LLC
- Practice address
- 3812 Market St
Camp Hill, PA 17011-4356 - Phone
- (717) 458-2027
- Fax
- (717) 632-1165
- NPI assigned
- Aug 24, 2023
- 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
- Dr. Wanna Stephanie Jean Mary, DPM
- Title
- Podiatrist
- Phone
- (216) 334-3348
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Foot & Ankle Surgery Podiatrist | 213ES0103X | Primary |
Addresses
Primary practice location
3812 Market St
Camp Hill, PA 17011-4356
Mailing address
250 Fame Ave Ste 220
Hanover, PA 17331-1587
Phone (717) 632-5264
Other practice location 1
250 Fame Ave Ste 220
Hanover, PA 17331-1587
Phone (717) 632-5264
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
Enrollment records 2
National Provider Directory
National Provider DirectoryLocations
3812 Market St
Camp Hill, PA 17011
Phone (717) 458-2027
150 N 12th St
Lemoyne, PA 17043
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Podiatrist
- Erie, PA
- NPI 1942707062
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1692835200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1693353600000",
"number": "1508640947",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "250 FAME AVE STE 220",
"city": "HANOVER",
"state": "PA",
"postal_code": "173311587",
"telephone_number": "717-632-5264",
"fax_number": "717-632-1165"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3812 MARKET ST",
"city": "CAMP HILL",
"state": "PA",
"postal_code": "170114356",
"telephone_number": "717-458-2027",
"fax_number": "717-632-1165"
}
],
"practiceLocations": [
{
"address_1": "250 Fame Ave Ste 220",
"address_purpose": "LOCATION",
"city": "Hanover",
"state": "PA",
"postal_code": "173311587",
"country_code": "US",
"telephone_number": "717-632-5264",
"fax_number": "717-632-1165",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "JEAN MARY LLC",
"organizational_subpart": "NO",
"enumeration_date": "2023-08-24",
"last_updated": "2023-08-30",
"certification_date": "2023-08-30",
"status": "A",
"authorized_official_last_name": "JEAN MARY",
"authorized_official_first_name": "WANNA",
"authorized_official_middle_name": "STEPHANIE",
"authorized_official_title_or_position": "PODIATRIST",
"authorized_official_telephone_number": "216-334-3348",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "DPM"
},
"taxonomies": [
{
"code": "213ES0103X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Podiatrist, Foot & Ankle Surgery",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Camp Hill, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2023; 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.