Wellspan Medical Group
Organization Active NPI Family Medicine Physician · Thurmont, MD
NPI 1881762995 · NPPES record last updated Jan 11, 2018
Key facts
- NPI
- 1881762995
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- WELLSPAN MEDICAL GROUP
- Practice address
- 52 Water St
Thurmont, MD 21788-1912 - Phone
- (301) 271-3535
- Fax
- (301) 271-2650
- NPI assigned
- Nov 30, 2006
- Organization subpart
- No
Authorized official
- Name
- Ms. Christina Vest
- Title
- Credentialing Supervisor
- Phone
- (717) 851-1405
Owned or controlled facilities with NPI records 1
Other NPIs on the same Medicare enrollment 6
Other NPIs with the same Medicare PAC ID 8
Practitioners 2,462
-
Richard Charles Bryson, M.D.
-
Virginia R Heard, MPT
-
Brian Holmes, MD
-
David Elliot Jamison, M.D.
-
Lee Gardie Jean, MD
-
Anver Saleem Khan, D.O.
-
Ali Imran Khawaja, M.D.
-
Lynne Ann Kline, CRNP
-
Andrew Nesmith, MD, MPH
-
Neil Patrick O'Malley, M.D.
-
Troy Anthony Sukhu, M.D.
-
Stacie Michelle Beaver, CRNP
-
Rebekah Rhiann Bruner, PT, DPT
-
Thomas Ryan Chang, M.D.
-
Mary Demino, DO
-
Karen Dillard, NP-C
-
Allison Megan Eliason, CRNP
-
Jay Lehman, M.D.
-
Leonid Levin, M.D.
-
Jeanette Adelle Linder, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in PA, MD
All facility ownership & control disclosures 1
| Facility | Type | Role | Since |
|---|---|---|---|
| Wellspan Internal Medicine |
Skilled nursing facility | Operational/Managerial Control Adp of the SNF |
Jun 29, 2015 Apr 8, 2025 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040220000815 | PA | Part B Supplier - Clinic/Group Practice | 1951213115 |
Receives reassigned benefits from 3,390 practitioners This NPI is an additional NPI on the enrollment |
| O20040507001210 | MD | Part B Supplier - Clinic/Group Practice | 1951213115 |
Receives reassigned benefits from 67 practitioners 6 other NPIs on this enrollment Practice locations: Hagerstown, MD |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | Yes | ||
| Nurse Practitioner |
363L00000X |
Addresses
Primary practice location
52 Water St
Thurmont, MD 21788-1912
Mailing address
1803 Mount Rose Ave
Suite B3
York, PA 17403-3051
Phone (717) 851-1405
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| CJ8326 | Other | PA | RAILROAD |
| 1382371 | Other | PA | HIGHMARK BLUE SHIELD |
| 401065501 | Medicaid | MD | |
| S1FD | Other | PA | GEISINGER |
| 20013086 | Other | PA | AMERIHEALTH MERCY |
| 1520447 | Other | PA | GATEWAY |
| KX10 | Other | MD | CAREFIRST MD BCBS |
| 1007721360131 | Medicaid | PA | |
| 03256300 | Other | PA | CAPITAL BLUE CROSS |
| 132622 | Other | PA | UNISON |
| 401065501 | Other | MD | MARYLAND MEDICAL ASSISTANCE |
| 7185822 | Other | PA | AETNA |
| 800174 | Other | PA | JOHN HOPKINS |
Other names
- WELLSPAN FAMILY MEDICINE - THURMONT
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All providers in Thurmont, MD · Family Medicine Physician in Maryland
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 11, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.