Individual provider Active NPI

John G Lieb, M.D.

  • Family Medicine Physician
  • Hanover, PA
National Provider Identifier
1821097577
Registry record updated Jul 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD028601E Issued in PA
Practice address
111 Penn St
Hanover, PA 17331-1929
Phone
(717) 632-4449
NPI assigned
Jul 15, 2005
Last updated
Jul 2, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD028601E PA Primary

Addresses

Primary practice location

111 Penn St
Hanover, PA 17331-1929

Mailing address

111 Penn St
Hanover, PA 17331-1929
Phone (717) 632-4449

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100914000405 PA Practitioner - Family Practice 7719885458 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Hanover Family Practice Associates, LLC Family Medicine CurrentSince May 26, 1983 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

100 Penn St
Ste D
Hanover, PA 17331
Phone (717) 632-0774

111 Penn St
Hanover, PA 17331
Phone (717) 632-0774

112 Clover Ln
Hanover, PA 17331
Phone (717) 632-4449

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1121385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278028800000",
    "number": "1821097577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 PENN ST",
            "city": "HANOVER",
            "state": "PA",
            "postal_code": "173311929",
            "telephone_number": "717-632-4449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 PENN ST",
            "city": "HANOVER",
            "state": "PA",
            "postal_code": "173311929",
            "telephone_number": "717-632-4449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIEB",
        "first_name": "JOHN",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-15",
        "last_updated": "2010-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD028601E",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hanover, PA

Sources for this page

Verify at the official NPI Registry.