PENN STATE HEALTH COMMUNITY MEDICAL GROUP, LLC (NPI# 1457824013) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457824013 |
| Entity Type | Organization |
| Organization Name | PENN STATE HEALTH COMMUNITY MEDICAL GROUP, LLC |
| Practice Address |
4520 Union Deposit Rd Harrisburg PA 17111-2910 |
| Practice Telephone | 7179094139 |
| Mailing Telephone | 7179094139 |
| Enumeration Date | 2019-01-07 |
| Last Update Date | 2019-01-07 |
| Authorized Official Name | STEPHEN MASSINI (EX. VICE PRES, CHIEF FINANCIAL OFC) |
| Authorized Official Telephone | 7175316614 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891394441 | Penn State Health Community Medical Group, LLC | Physical Therapist | 1800 Center St Ste 1a110, Camp Hill, PA 17011-1702 | 2020-10-23 |
| 1730607755 | Penn State Health Community Medical Group, LLC | Internal Medicine | 233 College Ave Ste 303, Lancaster, PA 17603-3384 | 2017-08-30 |
| 1750373965 | Penn State Health Community Medical Group, LLC | Non-Pharmacy Dispensing Site | 3912 Trindle Rd, Camp Hill, PA 17011-4246 | 2005-08-16 |
| 1801433149 | Penn State Health Community Medical Group, LLC | Internal Medicine | 50 N 12th St, Lemoyne, PA 17043-1440 | 2019-12-05 |
| 1609347152 | Penn State Health Community Medical Group, LLC | Pediatrics | 655 Walnut St, West Reading, PA 19611-1242 | 2018-12-10 |
| 1952897738 | Penn State Health Community Medical Group, LLC | Family Medicine | 5 S Centre Ave, Leesport, PA 19533 | 2018-07-05 |
| 1861988644 | Penn State Health Community Medical Group, LLC | Clinical Medical Laboratory | 3912 Trindle Rd, Camp Hill, PA 17011-4246 | 2018-07-05 |
| 1568976496 | Penn State Health Community Medical Group, LLC | Non-Pharmacy Dispensing Site | 4518 Union Deposit Rd, Harrisburg, PA 17111-2921 | 2017-11-30 |
| 1972032761 | Penn State Health Community Medical Group, LLC | Dietitian, Registered | 2301 Columbia Ave, Lancaster, PA 17603-4154 | 2017-06-06 |
| Street Address |
4520 UNION DEPOSIT RD |
| City | HARRISBURG |
| State | PA |
| Zip Code | 17111-2910 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518964865 | Christopher Ladd | Radiology | 4520 Union Deposit Rd, Harrisburg, PA 17111-2910 | 2005-07-01 |
| 1417374448 | Daniel Esslinger | Radiology | 4520 Union Deposit Rd, Harrisburg, PA 17111-2910 | 2014-03-27 |
| 1093708570 | Brian P Bloom | Radiology | 4520 Union Deposit Rd, Harrisburg, PA 17111-2910 | 2005-08-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417589011 | Brightwood Adult Day Care LLC | Clinic/Center | 5630 Derry Street, Harrisburg, PA 17111 | 2020-02-11 |
| 1114486008 | Candy Benson | Behavior Technician | 2225 Sycamore St Suite 240, Harrisburg, PA 17111 | 2019-03-19 |
| 1295203206 | Shannon Ingram | Behavior Technician | 2225 Sycamore St Suite 120, Harrisburg, PA 17111 | 2018-11-07 |
| 1255862678 | A Caring Hand Home Health Care LLC | Home Health | 5600 Derry St, Harrisburg, PA 17111 | 2017-03-27 |
| 1073067559 | Migliore Treatment Services LLC | Community/Behavioral Health | 60 S 41st St, Harrisburg, PA 17111 | 2016-08-12 |
| 1013384718 | Alina N Glazunova | Nurse Practitioner | 6010 Pindeale Court, Harrisburg, PA 17111 | 2015-08-28 |
| 1033551494 | Elizabeth Ann Campbell | Behavioral Analyst | 2225 Sycamore Street, Suite 120, Harrisburg, PA 17111 | 2013-07-25 |
| 1427320688 | Joseph J Trautlein | Allergy & Immunology | 6450 Colchester Ave, Harrisburg, PA 17111 | 2012-02-03 |
| 1083983019 | Bonsall Manfredi & Assoc, P.C. | Psychiatry & Neurology | 2600 Woodlawn Street, Harrisburg, PA 17111 | 2011-12-20 |
| 1083920045 | Mh Medical LLC | Durable Medical Equipment & Medical Supplies | 7412 Derry Street, Harrisburg, PA 17111 | 2010-08-27 |
| Find all providers in zip 17111 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| 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 Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669568929 | Pennsylvania Open Mri of Harrisburg, Inc. | Radiology | 5400 Chambers Hill Rd Ste D, Harrisburg, PA 17111-2547 | 2006-10-05 |
| 1720078629 | Hisham T Youssef | Radiology | 112 E Clark St, Harrisburg, IL 62946-2703 | 2005-10-24 |
| 1235126251 | Barbara Karlheim Kunkel | Radiology | 4230 Crums Mill Rd, Harrisburg, PA 17112-2898 | 2005-10-04 |
| 1922091404 | Jinan O Bahia | Radiology | 4518 Union Deposit Rd, Harrisburg, PA 17111-2921 | 2005-08-30 |
| 1518964865 | Christopher Ladd | Radiology | 4520 Union Deposit Rd, Harrisburg, PA 17111-2910 | 2005-07-01 |
| 1417374448 | Daniel Esslinger | Radiology | 4520 Union Deposit Rd, Harrisburg, PA 17111-2910 | 2014-03-27 |
| 1366711673 | Tristan Radiology Specialists, P.C. | Radiology | 4518 Union Deposit Rd, Harrisburg, PA 17111-2921 | 2011-12-16 |
| 1710270731 | Brian Scott Bentley | Radiology | 4518 Union Deposit Rd, Harrisburg, PA 17111 | 2011-05-24 |
| 1386876274 | Joella E Wilson | Radiology | 4300 Londonderry Rd, Harrisburg, PA 17109-5317 | 2009-08-11 |
| 1750501987 | Ct Scan Center, Inc. | Radiology | 112 E Clark St, Harrisburg, IL 62946-2703 | 2007-04-30 |
| Find all providers in HARRISBURG | ||||
| City | HARRISBURG |
| Zip Code | 17111 |
Please comment or provide details below to improve the information on PENN STATE HEALTH COMMUNITY MEDICAL GROUP, LLC.
| 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.