NPIMap

Organization Active NPI

OB-GYN of Lancaster, Inc Adv Nursing Prov

  • Advanced Practice Midwife
  • Lancaster, PA
National Provider Identifier
1841472859
Registry record updated Aug 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
MW008165L Issued in PA
Legal business name
OB-GYN OF LANCASTER, INC ADV NURSING PROV
Practice address
1059 Columbia Ave
Lancaster, PA 17603-3130
Phone
(717) 397-7085
Fax
(717) 390-2584
NPI assigned
Nov 30, 2007
Last updated
Aug 29, 2008By the provider in NPPES
Organization subpart
Yes
Parent organization
OB-GYN OF LANCASTER, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 29, 2008

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

Authorized official

Name
Diane M Streck, LPN, CAC
Title
Credentialing
Phone
(717) 390-2589

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Nurse PractitionerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 363LX0001X UP1001076G PA
Advanced Practice MidwifeGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 367A00000X MW010049 PA
Advanced Practice MidwifeGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 367A00000X MW008165L PA Primary
Advanced Practice MidwifeGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 367A00000X MW008081L PA
Advanced Practice MidwifeGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 367A00000X MW008560L PA

Addresses

Primary practice location

1059 Columbia Ave
Lancaster, PA 17603-3130

Mailing address

1059 Columbia Ave
Lancaster, PA 17603-3130
Phone (717) 397-7085

Other identifiers 2

IdentifierTypeStateIssuer
1007423330007MedicaidPA
102138829MedicaidPA

Other names 1

  • OB-GYN of Lancaster, Inc Former legal business name

National Provider Directory

National Provider Directory
Part of
OB-GYN of Lancaster Inc Adv Nursing Prov

Locations

1059 Columbia Ave
Lancaster, PA 17603
Phone (717) 390-2589

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 13

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 13

NPI Registry JSON

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

{
    "created_epoch": "1196380800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219968000000",
    "number": "1841472859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1059 COLUMBIA AVE",
            "city": "LANCASTER",
            "state": "PA",
            "postal_code": "176033130",
            "telephone_number": "717-397-7085",
            "fax_number": "717-390-2584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1059 COLUMBIA AVE",
            "city": "LANCASTER",
            "state": "PA",
            "postal_code": "176033130",
            "telephone_number": "717-397-7085",
            "fax_number": "717-390-2584"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OB-GYN OF LANCASTER, INC ADV NURSING PROV",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "OB-GYN OF LANCASTER, INC",
        "enumeration_date": "2007-11-30",
        "last_updated": "2008-08-29",
        "status": "A",
        "authorized_official_last_name": "STRECK",
        "authorized_official_first_name": "DIANE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "717-390-2589",
        "authorized_official_credential": "LPN, CAC"
    },
    "taxonomies": [
        {
            "code": "363LX0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "PA",
            "license": "UP1001076G",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Advanced Practice Midwife",
            "state": "PA",
            "license": "MW010049",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Advanced Practice Midwife",
            "state": "PA",
            "license": "MW008165L",
            "primary": true
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Advanced Practice Midwife",
            "state": "PA",
            "license": "MW008081L",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Advanced Practice Midwife",
            "state": "PA",
            "license": "MW008560L",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007423330007",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102138829",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "OB-GYN of Lancaster, Inc",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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 Aug 29, 2008; 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.