NPIMap

Organization Active NPI

Wellspan Medical Group

Doing business as Wellspan Family Medicine - Thurmont

  • Family Medicine Physician
  • Thurmont, MD
National Provider Identifier
1881762995
Registry record updated Jan 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
WELLSPAN MEDICAL GROUP
Doing business as
Wellspan Family Medicine - Thurmont
Practice address
52 Water St
Thurmont, MD 21788-1912
Phone
(301) 271-3535
Fax
(301) 271-2650
NPI assigned
Nov 30, 2006
Last updated
Jan 11, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2018

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

Authorized official

Name
Ms. Christina Vest
Title
Credentialing Supervisor
Phone
(717) 851-1405

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X
Family Medicine Physician 207Q00000X Primary

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 13

IdentifierTypeStateIssuer
1007721360131MedicaidPA
401065501MedicaidMD
CJ8326OtherPARAILROAD
03256300OtherPACAPITAL BLUE CROSS
800174OtherPAJOHN HOPKINS
1382371OtherPAHIGHMARK BLUE SHIELD
S1FDOtherPAGEISINGER
1520447OtherPAGATEWAY
7185822OtherPAAETNA
132622OtherPAUNISON
20013086OtherPAAMERIHEALTH MERCY
401065501OtherMDMARYLAND MEDICAL ASSISTANCE
KX10OtherMDCAREFIRST MD BCBS

Other names 1

  • WELLSPAN FAMILY MEDICINE - THURMONT Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, MD2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
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

Other NPIs with the same Medicare PAC ID 8

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 6

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Wellspan Internal MedicineLititz, PA, CCN 395631 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Jun 29, 2015
Apr 8, 2025

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 71

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 71

NPI Registry JSON

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

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1515628800000",
    "number": "1881762995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1803 MOUNT ROSE AVE",
            "address_2": "SUITE B3",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174033051",
            "telephone_number": "717-851-1405",
            "fax_number": "301-271-2650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "52 WATER ST",
            "city": "THURMONT",
            "state": "MD",
            "postal_code": "217881912",
            "telephone_number": "301-271-3535",
            "fax_number": "301-271-2650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLSPAN MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-30",
        "last_updated": "2018-01-11",
        "status": "A",
        "authorized_official_last_name": "VEST",
        "authorized_official_first_name": "CHRISTINA",
        "authorized_official_title_or_position": "CREDENTIALING SUPERVISOR",
        "authorized_official_telephone_number": "717-851-1405",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007721360131",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "401065501",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD",
            "identifier": "CJ8326",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPITAL BLUE CROSS",
            "identifier": "03256300",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JOHN HOPKINS",
            "identifier": "800174",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "1382371",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GEISINGER",
            "identifier": "S1FD",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GATEWAY",
            "identifier": "1520447",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7185822",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNISON",
            "identifier": "132622",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH MERCY",
            "identifier": "20013086",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MARYLAND MEDICAL ASSISTANCE",
            "identifier": "401065501",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST MD BCBS",
            "identifier": "KX10",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WELLSPAN FAMILY MEDICINE - THURMONT",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Thurmont, MD

Sources for this page

Verify at the official NPI Registry.