NPIMap

Organization Active NPI

Northern Lancaster County Medical Group

Doing business as WellSpan Family Health - Georgetown

  • Family Medicine Physician
  • Christiana, PA
National Provider Identifier
1780016253
Registry record updated May 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD053840L Issued in PA
Legal business name
NORTHERN LANCASTER COUNTY MEDICAL GROUP
Doing business as
WellSpan Family Health - Georgetown
Practice address
1135 Georgetown Road
Suite 201
Christiana, PA 17509
Phone
(717) 806-3800
Fax
(717) 806-3799
NPI assigned
Aug 6, 2013
Last updated
May 5, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 5, 2015

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

Authorized official

Name
Dr. Charles David Noll, DO
Title
Vice President
Phone
(717) 859-5161

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD053840L PA Primary

Addresses

Primary practice location

1135 Georgetown Road
Suite 201
Christiana, PA 17509

Mailing address

4131 Oregon Pike
Suite C
Ephrata, PA 17522-9550
Phone (717) 859-5161

Other identifiers 1

IdentifierTypeStateIssuer
1013977730029MedicaidPA

Other names 1

  • WellSpan Family Health - Georgetown Doing business as

National Provider Directory

National Provider Directory

Locations

11 S State St
Ste St
Ephrata, PA 17522
Phone (717) 733-4559

1525 Oregon Pike
Ste 201
Lancaster, PA 17601
Phone (717) 295-3012

266 Granite Run Dr
Lancaster, PA 17601
Phone (717) 733-6546

Practitioners & affiliated clinicians

Practitioners 36

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.

View all 36

NPI Registry JSON

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

{
    "created_epoch": "1375747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1430784000000",
    "number": "1780016253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4131 OREGON PIKE",
            "address_2": "SUITE C",
            "city": "EPHRATA",
            "state": "PA",
            "postal_code": "175229550",
            "telephone_number": "717-859-5161",
            "fax_number": "717-859-5169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1135 GEORGETOWN ROAD",
            "address_2": "SUITE 201",
            "city": "CHRISTIANA",
            "state": "PA",
            "postal_code": "17509",
            "telephone_number": "717-806-3800",
            "fax_number": "717-806-3799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHERN LANCASTER COUNTY MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-06",
        "last_updated": "2015-05-05",
        "status": "A",
        "authorized_official_last_name": "NOLL",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "717-859-5161",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD053840L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1013977730029",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WellSpan Family Health - Georgetown",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Christiana, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2015; 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.