Diakon Medical Group LLC

Primary specialty

Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X

Legal business name

DIAKON MEDICAL GROUP LLC

Practice address

280 Middle Holland Rd
Holland, PA 18966-4822

Phone

(717) 795-0457

Fax

(717) 796-6801

NPI assigned

Dec 28, 2016

Last updated

Apr 11, 2019By 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

Mr. Scott D Habecker

Title

Evp/Coo/Cfo

Phone

(717) 795-0384

Specialties & licenses 2

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Laurel Lea Spencer, MSW

  • Clinical Social Worker
  • Williamsport, PA
  • NPI 1043386444
  NPD

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

{
    "created_epoch": "1482883200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1554940800000",
    "number": "1689119794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1022 N UNION ST",
            "city": "MIDDLETOWN",
            "state": "PA",
            "postal_code": "170572158",
            "telephone_number": "717-795-0384",
            "fax_number": "717-795-0353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "280 MIDDLE HOLLAND RD",
            "city": "HOLLAND",
            "state": "PA",
            "postal_code": "189664822",
            "telephone_number": "717-795-0457",
            "fax_number": "717-796-6801"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1020 N Union St",
            "address_purpose": "LOCATION",
            "city": "Middletown",
            "state": "PA",
            "postal_code": "170572158",
            "country_code": "US",
            "telephone_number": "717-795-0457",
            "fax_number": "717-796-6801",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "19800 Tranquility Cir",
            "address_purpose": "LOCATION",
            "city": "Hagerstown",
            "state": "MD",
            "postal_code": "217424042",
            "country_code": "US",
            "telephone_number": "717-795-0457",
            "fax_number": "717-796-6801",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "276 Green Ave Ext",
            "address_purpose": "LOCATION",
            "city": "Lewistown",
            "state": "PA",
            "postal_code": "170449707",
            "country_code": "US",
            "telephone_number": "717-795-0457",
            "fax_number": "717-796-6801",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "30 Old Schuylkill Rd",
            "address_purpose": "LOCATION",
            "city": "Pottstown",
            "state": "PA",
            "postal_code": "194657971",
            "country_code": "US",
            "telephone_number": "717-795-0457",
            "fax_number": "717-796-6801",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1183 Luther Dr",
            "address_purpose": "LOCATION",
            "city": "Hagerstown",
            "state": "MD",
            "postal_code": "217407407",
            "country_code": "US",
            "telephone_number": "717-795-0457",
            "fax_number": "717-796-6801",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Longsdorf Way",
            "address_purpose": "LOCATION",
            "city": "Carlisle",
            "state": "PA",
            "postal_code": "170157623",
            "country_code": "US",
            "telephone_number": "717-795-0457",
            "fax_number": "717-796-6801",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "DIAKON MEDICAL GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-28",
        "last_updated": "2019-04-11",
        "status": "A",
        "authorized_official_last_name": "HABECKER",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "EVP/COO/CFO",
        "authorized_official_telephone_number": "717-795-0384",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jillian M Dashiell, MD
• Joseph Thomas De Carlo, D.C.
• John Calvin Deitz, BS RDGS RDCS RVT
• Diagraphics
• Diakon Lutheran Social Ministries (Twining Hall)
• Donald Louis Doyle, DC
• Kristen Patrice Doyle, DC
• Dr. Joshua E. Roberts, P.C.
• Emerald Human Services Inc
• Lauren Schwartz Enders, M.A., CCC-SLP

• Geriatric Medicine (Internal Medicine) Physician in Holland, PA
• Providers in Holland, PA by specialty
• Geriatric Medicine (Internal Medicine) Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2019; 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.