NPIMap

Organization Active NPI

Great Cove Integrative Medicine LLC

  • Internal Medicine Physician
  • McConnellsburg, PA
National Provider Identifier
1710015235
Registry record updated Apr 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD067389L Issued in PA
Legal business name
GREAT COVE INTEGRATIVE MEDICINE LLC
Practice address
124 S 2ND St
MC Connellsburg, PA 17233-1446
Phone
(717) 485-4131
Fax
(717) 485-3394
NPI assigned
Feb 28, 2007
Last updated
Apr 20, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2012

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

Authorized official

Name
Dr. Sharon Eunice Martin, MD PHDNPI 1891884375
Title
Owner
Phone
(717) 485-4131

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD067389L PA Primary

Addresses

Primary practice location

124 S 2ND St
MC Connellsburg, PA 17233-1446

Mailing address

124 S 2ND St
MC Connellsburg, PA 17233-1446
Phone (717) 485-4131

Other identifiers 3

IdentifierTypeStateIssuer
133213OtherPAHIGHMARK BLUE SHIELD
0017504800005MedicaidPA
5008657OtherPACAPITAL BLUE CROSS

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1334880000000",
    "number": "1710015235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 S 2ND ST",
            "city": "MC CONNELLSBURG",
            "state": "PA",
            "postal_code": "172331446",
            "telephone_number": "717-485-4131",
            "fax_number": "717-485-3394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 S 2ND ST",
            "city": "MC CONNELLSBURG",
            "state": "PA",
            "postal_code": "172331446",
            "telephone_number": "717-485-4131",
            "fax_number": "717-485-3394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT COVE INTEGRATIVE MEDICINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-28",
        "last_updated": "2012-04-20",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "SHARON",
        "authorized_official_middle_name": "EUNICE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "717-485-4131",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD PHD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD067389L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "133213",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0017504800005",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPITAL BLUE CROSS",
            "identifier": "5008657",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in McConnellsburg, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2012; 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.