Northeran Lancaster County Medical Group

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

NORTHERAN LANCASTER COUNTY MEDICAL GROUP

Practice address

446 N Reading Rd
Suite 301
Ephrata, PA 17522-9802

Phone

(717) 733-6546

Fax

(717) 733-6011

NPI assigned

Jul 5, 2012

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 1

Other names 1

• Wellspan Internal Medicine Doing business as

Locations

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

{
    "created_epoch": "1341446400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1432684800000",
    "number": "1962767012",
    "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",
            "fax_number": "717-859-5169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "446 N READING RD",
            "address_2": "SUITE 301",
            "city": "EPHRATA",
            "state": "PA",
            "postal_code": "175229802",
            "telephone_number": "717-733-6546",
            "fax_number": "717-733-6011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHERAN LANCASTER COUNTY MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-05",
        "last_updated": "2015-05-27",
        "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": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1013977730021",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wellspan Internal Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• David Nguyen, CRNA
• Dawn Elaine Noll, CRNA
• Wendy Ann Noll, CRNA
• Geoffrey Scott Nolt, D.M.D
• Marvin Benner Nolt, D.D.S
• Northern Lancaster County Medical Group
• Northern Lancaster County Medical Group
• Northern Lancaster County Medical Group
• Northern Lancaster County Medical Group
• Northern Lancaster County Medical Group

• Internal Medicine Physician in Ephrata, PA
• Providers in Ephrata, PA by specialty
• Internal Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 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.