NPIMap

Lancaster General Medical Group

Organization Active NPI Psychiatry Physician · Lancaster, PA

NPI 1952392383 · NPPES record last updated Nov 16, 2020

Key facts

NPI
1952392383
Entity type
Organization (NPI type 2)
Primary specialty
Psychiatry Physician 2084P0800X
Legal business name
LANCASTER GENERAL MEDICAL GROUP
Practice address
802 New Holland Ave
Lancaster, PA 17602-2163
Phone
(717) 560-3782
Fax
(717) 560-3787
NPI assigned
Nov 3, 2005
Organization subpart
No

Authorized official

Name
Denise A Kennedy
Title
VP Financial Services
Phone
(717) 544-5010

Other NPIs with the same Medicare PAC ID 7

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

Practitioners 905

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

View all 905

Medicare participation

Medicare fee-for-service enrollment
Enrolled in PA

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20040309000916 PA Part B Supplier - Clinic/Group Practice 0941103683 Receives reassigned benefits from 886 practitioners

National Provider Directory

Locations

2104 Harrisburg Pike
Ste 200
Lancaster, PA 17601
Phone (717) 290-3626

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor
Group: 193200000X MULTI-SPECIALTY GROUP		 101YP2500X
Psychologist
Group: 193200000X MULTI-SPECIALTY GROUP		 103T00000X
Clinical Social Worker
Group: 193200000X MULTI-SPECIALTY GROUP		 1041C0700X
Marriage & Family Therapist
Group: 193200000X MULTI-SPECIALTY GROUP		 106H00000X
Psychiatry Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 2084P0800X Yes
Psychiatric/Mental Health Nurse Practitioner
Group: 193200000X MULTI-SPECIALTY GROUP		 363LP0808X

Addresses

Primary practice location

802 New Holland Ave
Lancaster, PA 17602-2163

Mailing address

802 New Holland Ave
Lancaster, PA 17602-2163
Phone (717) 560-3782

Other identifiers

IdentifierTypeStateIssuer
5702513OtherPAAETNA NON-HMO
1007327490137OtherPACBHNP
817506OtherPAAETNA HMO
774495OtherPAHIGHMARK BLUE SHIELD
A159896OtherPAVALUE OPTIONS
CC7536OtherPARAILROAD MEDICARE
03092800OtherPACAPITAL BLUE CROSS
1551623OtherPAGATEWAY HEALTH PLAN

Other names

  • Penn Medicine LGHP Behavioral Health Doing business as

Electronic endpoints

TypeEndpointUseAffiliation
CONNECT URL https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Cobius Healthcare Solutions

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Nov 16, 2020.

{
    "created_epoch": "1130976000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1605484800000",
    "number": "1952392383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "802 NEW HOLLAND AVE",
            "city": "LANCASTER",
            "state": "PA",
            "postal_code": "176022163",
            "telephone_number": "717-560-3782",
            "fax_number": "717-560-3787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "802 NEW HOLLAND AVE",
            "city": "LANCASTER",
            "state": "PA",
            "postal_code": "176022163",
            "telephone_number": "717-560-3782",
            "fax_number": "717-560-3787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LANCASTER GENERAL MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-03",
        "last_updated": "2020-11-16",
        "certification_date": "2020-11-16",
        "status": "A",
        "authorized_official_last_name": "KENNEDY",
        "authorized_official_first_name": "DENISE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "VP FINANCIAL SERVICES",
        "authorized_official_telephone_number": "717-544-5010"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA NON-HMO",
            "identifier": "5702513",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CBHNP",
            "identifier": "1007327490137",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO",
            "identifier": "817506",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "774495",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "A159896",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CC7536",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPITAL BLUE CROSS",
            "identifier": "03092800",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GATEWAY HEALTH PLAN",
            "identifier": "1551623",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1068.1",
            "affiliationName": "Cobius Healthcare Solutions",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "2720 Dundee Rd # 302",
            "city": "Northbrook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600622609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Penn Medicine LGHP Behavioral Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lancaster, PA

All providers in Lancaster, PA · Psychiatry Physician in Pennsylvania

Sources for this page

Verify at the official NPI Registry.