Active NPI
Wellspan Medical Group
- Family Medicine Physician
- York, PA
National Provider Identifier
1659449031
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- Legal business name
- WELLSPAN MEDICAL GROUP
- Practice address
- 1010 Plymouth Rd
York, PA 17402-3864 - Phone
- (717) 851-1800
- Fax
- (717) 851-1810
- NPI assigned
- Dec 1, 2006
- 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
- Ms. Christina Vest
- Title
- Credentialing Supervisor
- Phone
- (717) 851-1405
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | Primary |
Addresses
Primary practice location
1010 Plymouth Rd
York, PA 17402-3864
Mailing address
1803 Mount Rose Ave
Suite B3
York, PA 17403-3051
Phone (717) 851-1405
Other identifiers 12
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0202925002 | Other | PA | AMERIHEALTH 65 PA |
| 5203300 | Other | PA | AETNA |
| 1007721360099 | Medicaid | PA | |
| 1142354 | Other | PA | AMERIHEALTH MERCY |
| S1ES | Other | PA | GEISINGER |
| KX10 | Other | MD | CAREFIRST MD BCBS |
| 1519295 | Other | PA | GATEWAY |
| 800174 | Other | PA | JOHN HOPKINS |
| 02293800 | Other | PA | CAPITAL BLUE CROSS |
| 501286 | Other | PA | HIGHMARK BLUE SHIELD |
| 82193 | Other | PA | UNISON |
| CA3246 | Other | PA | RAILROAD MEDICARE |
Other names 1
- WELLSPAN FAMILY MEDICINE - PLYMOUTH RD
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040220000815 | PA | Part B Supplier - Clinic/Group Practice | 1951213115 |
Receives reassigned benefits from 3,390 practitioners This NPI is an additional NPI on the enrollment |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Hospitalist Physician
- Chambersburg, PA
- NPI 1205941796
-
- Interventional Cardiology Physician
- Chambersburg, PA
- NPI 1073514550
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164931200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1515628800000",
"number": "1659449031",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1803 MOUNT ROSE AVE",
"address_2": "SUITE B3",
"city": "YORK",
"state": "PA",
"postal_code": "174033051",
"telephone_number": "717-851-1405",
"fax_number": "717-851-1810"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1010 PLYMOUTH RD",
"city": "YORK",
"state": "PA",
"postal_code": "174023864",
"telephone_number": "717-851-1800",
"fax_number": "717-851-1810"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "WELLSPAN MEDICAL GROUP",
"organizational_subpart": "NO",
"enumeration_date": "2006-12-01",
"last_updated": "2018-01-11",
"status": "A",
"authorized_official_last_name": "VEST",
"authorized_official_first_name": "CHRISTINA",
"authorized_official_title_or_position": "CREDENTIALING SUPERVISOR",
"authorized_official_telephone_number": "717-851-1405",
"authorized_official_name_prefix": "Ms."
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Family Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERIHEALTH 65 PA",
"identifier": "0202925002",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "5203300",
"state": "PA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1007721360099",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERIHEALTH MERCY",
"identifier": "1142354",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GEISINGER",
"identifier": "S1ES",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAREFIRST MD BCBS",
"identifier": "KX10",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GATEWAY",
"identifier": "1519295",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "JOHN HOPKINS",
"identifier": "800174",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAPITAL BLUE CROSS",
"identifier": "02293800",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HIGHMARK BLUE SHIELD",
"identifier": "501286",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNISON",
"identifier": "82193",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "CA3246",
"state": "PA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "WELLSPAN FAMILY MEDICINE - PLYMOUTH RD",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in York, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2018; 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.