Active NPI
Northern Lancaster County Medical Group
- Family Medicine Physician
- Leola, PA
National Provider Identifier
1669414611
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- Legal business name
- NORTHERN LANCASTER COUNTY MEDICAL GROUP
- Practice address
- 15 Zimmerman Rd
Leola, PA 17540-1949 - Phone
- (717) 656-4922
- NPI assigned
- Jun 12, 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
- Cynthia Malizia
- Title
- VP Nlcmg
- Phone
- (717) 738-2280
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | Primary |
Addresses
Primary practice location
15 Zimmerman Rd
Leola, PA 17540-1949
Mailing address
PO Box 398
Brownstown, PA 17508-0398
Phone (717) 859-2038
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2412011000 | Other | PA | BLUE SHIELD |
| 7022107 | Other | PA | AETNA |
| 1538659 | Other | PA | CIGNA |
| 50051122 | Other | PA | BLUE CROSS |
Other names 1
- Bareville Medical Associates
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150070400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1669414611",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 398",
"city": "BROWNSTOWN",
"state": "PA",
"postal_code": "175080398",
"telephone_number": "717-859-2038"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15 ZIMMERMAN RD",
"city": "LEOLA",
"state": "PA",
"postal_code": "175401949",
"telephone_number": "717-656-4922"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "NORTHERN LANCASTER COUNTY MEDICAL GROUP",
"organizational_subpart": "NO",
"enumeration_date": "2006-06-12",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "MALIZIA",
"authorized_official_first_name": "CYNTHIA",
"authorized_official_title_or_position": "VP NLCMG",
"authorized_official_telephone_number": "717-738-2280"
},
"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": "BLUE SHIELD",
"identifier": "2412011000",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "7022107",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "1538659",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "50051122",
"state": "PA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Bareville Medical Associates",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Leola, PA
Sources for this page
- 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.