NPIMap

Organization Active NPI

Susquehanna Physician Services

Doing business as Susquehanna Health Medical Group

  • Family Medicine Physician
  • Williamsport, PA
National Provider Identifier
1831145515
Registry record updated Nov 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
SUSQUEHANNA PHYSICIAN SERVICES
Doing business as
Susquehanna Health Medical Group
Practice address
1201 Grampian Blvd
Williamsport, PA 17701-1900
Phone
(570) 326-8723
Fax
(570) 326-8922
NPI assigned
May 25, 2006
Last updated
Nov 24, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2015

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

Authorized official

Name
Ms. Melissa Davis
Title
VP/Coo
Phone
(570) 320-7696

Specialties & licenses 14

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X NU
Family Medicine Physician 207Q00000X NU Primary
Internal Medicine Physician 207R00000X NU
Cardiovascular Disease Physician 207RC0000X NU
Endocrinology, Diabetes & Metabolism Physician 207RE0101X NU
Interventional Cardiology Physician 207RI0011X NU
Pulmonary Disease Physician 207RP1001X NU
Rheumatology Physician 207RR0500X NU
Otolaryngology Physician 207Y00000X NU
Pediatrics Physician 208000000X NU
Physical Medicine & Rehabilitation Physician 208100000X NU
Psychiatry Physician 2084P0800X NU
Surgery Physician 208600000X NU
Pain Medicine Physician 208VP0000X NU

Addresses

Primary practice location

1201 Grampian Blvd
Williamsport, PA 17701-1900

Mailing address

1201 Grampian Blvd
Williamsport, PA 17701-1900

Other names 1

  • Susquehanna Health Medical Group Doing business as

National Provider Directory

National Provider Directory
Tax ID family
SPS LH Family Practice26 organizations share this tax ID, including this one

Other organizations with this tax ID 25

Organizations that report the same tax identification number in the National Provider Directory.

View all 25

Locations

1705 Warren Ave
Ste 101
Williamsport, PA 17701
Phone (570) 322-0609

NPI Registry JSON

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

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1448323200000",
    "number": "1831145515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 GRAMPIAN BLVD",
            "city": "WILLIAMSPORT",
            "state": "PA",
            "postal_code": "177011900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 GRAMPIAN BLVD",
            "city": "WILLIAMSPORT",
            "state": "PA",
            "postal_code": "177011900",
            "telephone_number": "570-326-8723",
            "fax_number": "570-326-8922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUSQUEHANNA PHYSICIAN SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-25",
        "last_updated": "2015-11-24",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_title_or_position": "VP/COO",
        "authorized_official_telephone_number": "570-320-7696",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Susquehanna Health Medical Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Williamsport, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 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.