NPIMap

Organization Active NPI

Pequea Valley Internal Medicine, Inc.

  • Internal Medicine Physician
  • Lancaster, PA
National Provider Identifier
1831253467
Registry record updated Dec 28, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
PEQUEA VALLEY INTERNAL MEDICINE, INC.
Practice address
1725 Oregon Pike
Suite 107 B
Lancaster, PA 17601-4206
Phone
(717) 560-3505
NPI assigned
Dec 20, 2006
Last updated
Dec 28, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2007

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

Authorized official

Name
Ms. Jessica R Lacorte, RN
Title
Practice Administrator
Phone
(717) 560-3505

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X NU
Family Medicine Physician 207Q00000X NU
Internal Medicine Physician 207R00000X NU Primary

Addresses

Primary practice location

1725 Oregon Pike
Suite 107 B
Lancaster, PA 17601-4206

Mailing address

1725 Oregon Pike
Suite 107 B
Lancaster, PA 17601-4206

Other identifiers 4

IdentifierTypeStateIssuer
50041137OtherPACAP BC
0016560860002MedicaidPA
1646737OtherPABLUESHIELD
DC7495OtherPARR MCR

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

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": "1166572800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1198800000000",
    "number": "1831253467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1725 OREGON PIKE",
            "address_2": "SUITE 107 B",
            "city": "LANCASTER",
            "state": "PA",
            "postal_code": "176014206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1725 OREGON PIKE",
            "address_2": "SUITE 107 B",
            "city": "LANCASTER",
            "state": "PA",
            "postal_code": "176014206",
            "telephone_number": "717-560-3505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEQUEA VALLEY INTERNAL MEDICINE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-20",
        "last_updated": "2007-12-28",
        "status": "A",
        "authorized_official_last_name": "LACORTE",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "717-560-3505",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAP BC",
            "identifier": "50041137",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0016560860002",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUESHIELD",
            "identifier": "1646737",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MCR",
            "identifier": "DC7495",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lancaster, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2007; 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.