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

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

Other NPIs on the same Medicare enrollment 6

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

Other NPIs with the same Medicare PAC ID 8

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

Practitioners 2,462

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 2,462

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in PA, MD

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 Medicine
Lititz, PA · CCN 395631
Skilled nursing facility Operational/Managerial Control
Adp of the SNF
Jun 29, 2015
Apr 8, 2025

Medicare enrollment records

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

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207Q00000X Yes
Nurse Practitioner
Group: 193200000X MULTI-SPECIALTY GROUP
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

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

Other names

  • WELLSPAN FAMILY MEDICINE - THURMONT Doing business as

Other providers in Thurmont, MD

All providers in Thurmont, MD · Family Medicine Physician in Maryland

Sources for this page

Verify at the official NPI Registry.