Northern Lancaster County Medical Group

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

NORTHERN LANCASTER COUNTY MEDICAL GROUP

Practice address

337 W Main St
Suite 100
Leola, PA 17540-2109

Phone

(717) 656-6122

Fax

(717) 656-0142

NPI assigned

May 26, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Charles David Noll, DO

Title

Vice President

Phone

(717) 859-5161

Specialties & licenses 1

Addresses

Other identifiers 6

Other names 1

• WellSpan Family Medicine - Meadowbrook Doing business as

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1430784000000",
    "number": "1932155181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4131 OREGON PIKE",
            "address_2": "SUITE C",
            "city": "EPHRATA",
            "state": "PA",
            "postal_code": "175229550",
            "telephone_number": "717-859-5161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "337 W MAIN ST",
            "address_2": "SUITE 100",
            "city": "LEOLA",
            "state": "PA",
            "postal_code": "175402109",
            "telephone_number": "717-656-6122",
            "fax_number": "717-656-0142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHERN LANCASTER COUNTY MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-26",
        "last_updated": "2015-05-05",
        "status": "A",
        "authorized_official_last_name": "NOLL",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "717-859-5161",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GATEWAY",
            "identifier": "1517089",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5372553",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1013977730018",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "1746348",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPITAL BLUE CROSS",
            "identifier": "50051234",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "DD6938",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WellSpan Family Medicine - Meadowbrook",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Richard H. Niemeyer, M.D.
• Lynette Marie Nisly, LCSW
• Nissley Family Chiropractic
• Barbara Jane Nistor, CRNP
• Northern Lancaster County Medical Group
• Erica Ostrum
• Melody J Peck, LCT, SDNM
• Pennsylvania Dental Partners, LLC
• Physicians Dialysis of Lancaster, LLC
• Dietmar Pilz, D.D.S.

• All providers in Leola, PA
• Family Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2015; 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.