Organization Active NPI

Lancaster County Podiatry LLP

  • Podiatrist
  • Ephrata, PA
National Provider Identifier
1801873690
Registry record updated Apr 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
Legal business name
LANCASTER COUNTY PODIATRY LLP
Practice address
804 Grandview Dr
Ste 1
Ephrata, PA 17522-1635
Phone
(717) 733-2251
NPI assigned
Dec 22, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2008

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

Authorized official

Name
Charles S Yeager, DPM
Title
Partner
Phone
(717) 733-2251

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X Primary

Addresses

Primary practice location

804 Grandview Dr
Ste 1
Ephrata, PA 17522-1635

Mailing address

804 Grandview Dr
Ste 1
Ephrata, PA 17522-1635
Phone (717) 733-2251

Other identifiers 5

IdentifierTypeStateIssuer
1515009OtherPAGATEWAY
561286OtherPAAETNA
0018077160005MedicaidPA
02359500OtherPACAPITAL BLUE CROSS
541613OtherPAHIGHMARK BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040722000891 PA Part B Supplier - Clinic/Group Practice 6507846243 Receives reassigned benefits from 5 practitioners
Practice locations: Ephrata, PA; Lititz, PA; New Holland, PA
O20100930056287 PA DME Supplier - Physician - Podiatry 6507846243 Practice locations: Ephrata, PA

National Provider Directory

National Provider Directory

Locations

804 Grandview Dr
Ste 1
Ephrata, PA 17522
Phone (717) 627-2403

30 Copperfield Cir
Lititz, PA 17543

104 E Main St
Lititz, PA 17543
Phone (717) 626-1516

912 W Main St
Ste 202
New Holland, PA 17557
Phone (717) 656-8555

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1135209600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208304000000",
    "number": "1801873690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "804 GRANDVIEW DR",
            "address_2": "STE 1",
            "city": "EPHRATA",
            "state": "PA",
            "postal_code": "175221635",
            "telephone_number": "717-733-2251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "804 GRANDVIEW DR",
            "address_2": "STE 1",
            "city": "EPHRATA",
            "state": "PA",
            "postal_code": "175221635",
            "telephone_number": "717-733-2251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LANCASTER COUNTY PODIATRY LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-22",
        "last_updated": "2008-04-16",
        "status": "A",
        "authorized_official_last_name": "YEAGER",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "717-733-2251",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GATEWAY",
            "identifier": "1515009",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "561286",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0018077160005",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPITAL BLUE CROSS",
            "identifier": "02359500",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "541613",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ephrata, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2008; 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.

Verify at the official NPI Registry.