Lighthouse Medical LLC

Primary specialty

Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X

License

MD044867E Issued in PA

Legal business name

LIGHTHOUSE MEDICAL LLC

Doing business as

Lighthouse Medical Pain Management

Practice address

217 Glenn St
Suite 401
Cumberland, MD 21502-2460

Phone

(301) 722-7246

Fax

(301) 777-2624

NPI assigned

Apr 17, 2011

Organization subpart

No

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

Authorized official

Name

John H. Johnson, MD

Title

Ceo/Owner

Phone

(814) 943-1271

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Lighthouse Medical Pain Management Doing business as

Locations

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

{
    "created_epoch": "1302998400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1488240000000",
    "number": "1841580495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 E. PLEASANT VALLEY BLVD.",
            "city": "ALTOONA",
            "state": "PA",
            "postal_code": "16602",
            "telephone_number": "814-943-1271",
            "fax_number": "814-940-8516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "217 GLENN ST",
            "address_2": "SUITE 401",
            "city": "CUMBERLAND",
            "state": "MD",
            "postal_code": "215022460",
            "telephone_number": "301-722-7246",
            "fax_number": "301-777-2624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIGHTHOUSE MEDICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-17",
        "last_updated": "2017-02-28",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "H.",
        "authorized_official_title_or_position": "CEO/OWNER",
        "authorized_official_telephone_number": "814-943-1271",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "PA",
            "license": "MD044867E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3366359 00",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIST BC/BS",
            "identifier": "Y925",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lighthouse Medical Pain Management",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lisa Michele Lewis, RN, CDCES
• William Lewis, CRNA
• Jamie Lichty, CSCAD
• Lifetime Vision Care
• Lighthouse Medical LLC
• Amy Likens, OTA
• Bruce Andrew Liller, LCPC
• Dianne Liller
• Paul E Lin, DDS
• Lincare Inc

• Pain Medicine (Anesthesiology) Physician in Cumberland, MD
• Providers in Cumberland, MD by specialty
• Pain Medicine (Anesthesiology) Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2017; 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.