SUSQUEHANNA PHYSICIAN SERVICES (NPI# 1366470973) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366470973 |
| Entity Type | Organization |
| Organization Name | SUSQUEHANNA PHYSICIAN SERVICES |
| Other Organization Name | SPS-LOYALSOCK PEDIATRICS |
| Practice Address |
904 Campbell St Williamsport PA 17701-3166 |
| Mailing Address |
1201 Grampian Blvd Po Box 3127 Williamsport PA 17701-0127 |
| Practice Telephone | 5703213100 |
| Practice Fax Number | 5703213101 |
| Enumeration Date | 2006-06-30 |
| Last Update Date | 2010-05-26 |
| Authorized Official Name | MR. CHARLES SANTANGELO (EXECUTIVE VP/CFO) |
| Authorized Official Telephone | 5703213171 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | 0017300760190 | 05 | |
| PA | HIGHMARK BLUE SHIELD | 714360 | 01 |
| Other Name | Type Code |
|---|---|
| SPS-Loyalsock Pediatrics | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033345533 | Susquehanna Physician Services | Nurse Practitioner | 10 Shady Lane, Suite 201, Muncy, PA 17756-8807 | 2009-06-10 |
| 1477793172 | Susquehanna Physician Services | Physician Assistant | 1201 Grampian Blvd Ste 1a, Williamsport, PA 17701-1965 | 2009-02-20 |
| 1780603837 | Susquehanna Physician Services | Obstetrics & Gynecology | 2134 W 4th St, Williamsport, PA 17701-4344 | 2006-07-19 |
| 1083677868 | Susquehanna Physician Services | Internal Medicine | 700 High Street, Williamsport, PA 17701-3198 | 2006-04-11 |
| 1467453878 | Susquehanna Physician Services | Clinic/Center | 1112 Grampian Blvd, Williamsport, PA 17701-1909 | 2005-08-09 |
| 1578164943 | Susquehanna Physician Services | Podiatrist | 2370 Old Turnpike Rd Ste 4, Lewisburg, PA 17837-6567 | 2020-11-03 |
| 1982205472 | Susquehanna Physician Services | Clinic/Center | 416 S Main St Ste 1, Mansfield, PA 16933-1510 | 2020-11-03 |
| 1962018135 | Susquehanna Physician Services | Family Medicine | 700 High St Fl 9, Williamsport, PA 17701-3100 | 2020-09-22 |
| 1992359798 | Susquehanna Physician Services | Emergency Medicine | 700 High St, Williamsport, PA 17701-3100 | 2019-07-30 |
| 1689905606 | Susquehanna Physician Services | Nurse Practitioner | 777 Rural Ave, Williamsport, PA 17701-3109 | 2010-01-15 |
| Street Address |
904 CAMPBELL ST |
| City | WILLIAMSPORT |
| State | PA |
| Zip Code | 17701-3166 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467443705 | Linda B Loehr | Advanced Practice Midwife | 904 Campbell St, Williamsport, PA 17701-3166 | 2005-11-04 |
| 1780170449 | Rachael D. Kershner | Counselor | 904 Campbell St, Williamsport, PA 17701-3166 | 2018-07-06 |
| 1568798098 | Albert Gallatin Liddell IIi | Orthopaedic Surgery | 904 Campbell St, Ste.101, Williamsport, PA 17701-3166 | 2009-10-17 |
| 1235271560 | Hani J Tuffaha Md PC | Neurological Surgery | 904 Campbell St, Williamsport, PA 17701-3166 | 2007-02-13 |
| 1992857395 | Lycoming Neurosurgical Associates, Inc | Specialist | 904 Campbell St, Suite 104, Williamsport, PA 17701-3166 | 2007-01-17 |
| 1477619641 | Holly C Baney | Physician Assistant | 904 Campbell St, Suite 206, Williamsport, PA 17701-3166 | 2006-12-29 |
| 1417012030 | Renuka Kakarala | Internal Medicine | 904 Campbell St, Suite 102, Williamsport, PA 17701-3154 | 2006-12-26 |
| 1760414874 | Susquehanna Physician Services | Pediatrics | 904 Campbell St, Williamsport, PA 17701-3166 | 2006-07-07 |
| 1033140280 | Williamsport Obstetrics & Gynecology, P.C. | Obstetrics & Gynecology | 904 Campbell St, Suite 203, Williamsport, PA 17701-3166 | 2006-07-05 |
| 1174570618 | Susquehanna Physician Services | Family Medicine | 904 Campbell St, Suite 202, Williamsport, PA 17701-3165 | 2006-05-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184267809 | Charlene Angella Pitter | Nurse Practitioner | 170 Warren Ave, Williamsport, PA 17701 | 2019-10-25 |
| 1396395299 | Susan E Fetzer | Occupational Therapy Assistant | Upmc Susquehanna,625 West Edwin Street, Williamsport, PA 17701 | 2019-09-13 |
| 1184280984 | Craig Andrew Tuller | Student in an Organized Health Care Education/Training Program | Williamsport Family Medicine Residency, 740 High Street, Suite 4001, Williamsport, PA 17701 | 2019-05-16 |
| 1760048045 | Michael Harvey | Student in an Organized Health Care Education/Training Program | 740 High St. Suite 4001, Williamsport, PA 17701 | 2019-05-13 |
| 1275196008 | Olivia Fladmark | Student in an Organized Health Care Education/Training Program | Williamsport Family Medicine Residency 740 High St, Suite 4001, Williamsport, PA 17701 | 2019-04-17 |
| 1528551231 | Mark Hampton Chiropractic Inc. | Durable Medical Equipment & Medical Supplies | 1111 East 3rd Street, Williamsport, PA 17701 | 2018-06-08 |
| 1548710882 | Central Pennsylvania Rehabilitation Medicine, Inc | Physical Medicine & Rehabilitation | 460 River Ave Ste 1, Williamsport, PA 17701 | 2016-10-11 |
| 1376096784 | Christine Kessler | Physician Assistant | One College Ave, Penna. College of Tech, Pa Program Dif 123, Williamsport, PA 17701 | 2016-08-02 |
| 1629440276 | Matthew Ray Rebuck | Specialist/Technologist | 220 N Reach Rd, Williamsport, PA 17701 | 2015-10-22 |
| 1508237223 | Neihl Williamson | Physician Assistant | 1205 Grampian Blvd Ste 3c, Williamsport, PA 17701 | 2015-10-08 |
| Find all providers in zip 17701 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083600100 | Deborah L Barndt | Pediatrics | 2403 East Third Street, Williamsport, PA 17701 | 2005-09-23 |
| 1891796389 | Ralph H. Kaiser | Pediatrics | 471 Hepburn St, Williamsport, PA 17701-6122 | 2005-08-09 |
| 1639432628 | Ashley Nichole Pence | Pediatrics | 700 High Street, Williamsport, PA 17701-3198 | 2012-06-25 |
| 1831412246 | Susquehanna Community Health and Dental Clinic, Inc. | Pediatrics | 471 Hepburn St, Williamsport, PA 17701-6122 | 2010-03-12 |
| 1457474645 | Qasim Mahmood | Pediatrics | 700 High St, Williamsport, PA 17701-3198 | 2007-04-10 |
| 1760414874 | Susquehanna Physician Services | Pediatrics | 904 Campbell St, Williamsport, PA 17701-3166 | 2006-07-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093321622 | St Luke's Physician Group Inc | Pediatrics | 514 Delaware Ave, Fountain Hill, PA 18015-1104 | 2020-09-18 |
| 1972138204 | Margarita Bello | Pediatrics | 448 Walton Ave Unit 217, Hummelstown, PA 17036-4010 | 2020-03-06 |
| 1548809494 | Childen's Community Care | Pediatrics | 1811 Boulevard of The Allies Ste 200, Pittsburgh, PA 15219-5964 | 2019-12-24 |
| 1164069241 | Ayala Laufer-cahana | Pediatrics | 647 Montgomery School Ln, Wynnewood, PA 19096-1013 | 2019-12-08 |
| 1023652708 | Pediatric Care Group, P.C. | Pediatrics | 890 2nd Street Pike Ste 904, Richboro, PA 18954-1021 | 2019-11-05 |
| 1861036279 | Stc Pediatrics LLC | Pediatrics | 300 E Hunting Park Ave, Philadelphia, PA 19124-6018 | 2019-10-30 |
| 1679115760 | Rural Health Corporation of Northeastern Pennsylvania | Pediatrics | 1730 E Broad St Ste 2, Hazleton, PA 18201-5657 | 2019-10-10 |
| 1003462797 | Lucyndia Rose Marino | Pediatrics | 130 Classic Ln, New Castle, PA 16105-5304 | 2019-08-18 |
| 1861048803 | Geisinger Clinic | Pediatrics | 55 Medical Drive, Lewisburg, PA 17837-6343 | 2019-08-15 |
| 1447818729 | Elizabeth Edmondston Tarr | Pediatrics | 3401 Civic Center Blvd Fl 9nw55, Philadelphia, PA 19104-4319 | 2019-06-03 |
| Find all providers with the same taxonomy | ||||
| City | WILLIAMSPORT |
| Zip Code | 17701 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.