NPIMap

Organization Active NPI

Lycoming Physical Medicine

  • Durable Medical Equipment & Medical Supplies
  • Williamsport, PA
National Provider Identifier
1518345602
Registry record updated May 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
MD045007L Issued in PA
Legal business name
LYCOMING PHYSICAL MEDICINE
Doing business as
Lycoming Physical Medicine Williamsport DME
Practice address
1111 E 3Rd St
Williamsport, PA 17701-5411
Phone
(570) 326-0400
NPI assigned
May 11, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 12, 2015

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

Authorized official

Name
Dr. Mark Allen Hampton, D.C.
Title
Ceo
Phone
(570) 326-0400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X MD045007L PA Primary

Addresses

Primary practice location

1111 E 3Rd St
Williamsport, PA 17701-5411

Mailing address

1111 E 3Rd St
Williamsport, PA 17701-5411
Phone (570) 326-0400

Other names 1

  • Lycoming Physical Medicine Williamsport DME Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Lycoming Physical Medicine PC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1111 E 3rd St
Williamsport, PA 17701
Phone (570) 326-0400

NPI Registry JSON

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

{
    "created_epoch": "1431302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1431388800000",
    "number": "1518345602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 E 3RD ST",
            "city": "WILLIAMSPORT",
            "state": "PA",
            "postal_code": "177015411",
            "telephone_number": "570-326-0400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 E 3RD ST",
            "city": "WILLIAMSPORT",
            "state": "PA",
            "postal_code": "177015411",
            "telephone_number": "570-326-0400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LYCOMING PHYSICAL MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-11",
        "last_updated": "2015-05-12",
        "status": "A",
        "authorized_official_last_name": "HAMPTON",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "ALLEN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "570-326-0400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "PA",
            "license": "MD045007L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lycoming Physical Medicine Williamsport DME",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Williamsport, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.