Lebanon Pediatric Associates

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

MD016889E Issued in PA

Legal business name

LEBANON PEDIATRIC ASSOCIATES

Practice address

503 Oak St
Lebanon, PA 17042-6246

Phone

(717) 272-7695

NPI assigned

Aug 13, 2006

Last updated

Aug 22, 2020By 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

Mrs. Jacquelyn S. Frazier

Title

Billing Supervisor

Phone

(717) 838-6462

Specialties & licenses 1

Addresses

Other identifiers 3

Locations

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

{
    "created_epoch": "1155427200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1578575007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "503 OAK ST",
            "city": "LEBANON",
            "state": "PA",
            "postal_code": "170426246",
            "telephone_number": "717-272-7695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "503 OAK ST",
            "city": "LEBANON",
            "state": "PA",
            "postal_code": "170426246",
            "telephone_number": "717-272-7695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEBANON PEDIATRIC ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FRAZIER",
        "authorized_official_first_name": "JACQUELYN",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "BILLING SUPERVISOR",
        "authorized_official_telephone_number": "717-838-6462",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MD016889E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1008514360001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPITAL BLUE CROSS",
            "identifier": "01543601",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "407754",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lebanon Oral Surgery Group PLLC
• Lebanon Orthopaedic Associates
• Lebanon Outpatient Surgical Center L.P.
• Lebanon Pain Relief Center PC
• Lebanon Pathology Associates
• Lebanon Plastic Surgery Associates P C
• Lebanon School District
• Lebanon Surgical Associates, P.C.
• Lebanon VA Medical Center
• Lebanon Valley Counseling LLC

• Pediatrics Physician in Lebanon, PA
• Providers in Lebanon, PA by specialty
• Pediatrics Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.