WELLSPAN MEDICAL GROUP (NPI# 1730592940) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1730592940 |
Entity Type | Organization |
Organization Name | WELLSPAN MEDICAL GROUP |
Other Organization Name | WELLSPAN MEDICAL ONCOLOGY AND HEMATOLOGY |
Practice Address |
40 V Twin Dr Suite 104 Gettysburg PA 17325-7878 |
Mailing Address |
3421 Concord Rd York PA 17402-9001 |
Practice Telephone | 7173392560 |
Practice Fax Number | 7173340929 |
Mailing Telephone | 7173392560 |
Mailing Fax Number | 7173340929 |
Enumeration Date | 2014-06-05 |
Last Update Date | 2018-01-11 |
Authorized Official Name | MS. CHRISTINA VEST (CREDENTIALING SUPERVISOR) |
Authorized Official Telephone | 7178511405 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 207RH0000X |
Internal Medicine Specialization: Hematology |
Allopathic & Osteopathic Physicians | ||
N | 207RX0202X |
Internal Medicine Specialization: Medical Oncology |
Allopathic & Osteopathic Physicians | ||
Y | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
PA | 401065518 | 05 |
Other Name | Type Code |
---|---|
WELLSPAN MEDICAL ONCOLOGY AND HEMATOLOGY | Doing Business As Name - Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1962980730 | Wellspan Medical Group | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 40 V Twin Dr Ste 102, Gettysburg, PA 17325-7878 | 2018-08-02 |
1245490515 | Wellspan Medical Group | Surgery | 50 Wyntre Brooke Dr, York, PA 17403-4535 | 2008-06-11 |
1184784704 | Wellspan Medical Group | Internal Medicine | 40 V Twin Dr Ste 204, Gettysburg, PA 17325-7878 | 2006-12-12 |
1801954276 | Wellspan Medical Group | Internal Medicine | 296 St. Charles Way, York, PA 17402-4648 | 2006-12-05 |
1649348525 | Wellspan Medical Group | Physician Assistant | 105 4th St # 727, East Berlin, PA 17316-9638 | 2006-12-01 |
1790853695 | Wellspan Medical Group | Family Medicine | 4910a Fairfield Road, Fairfield, PA 17320-9510 | 2006-12-01 |
1801982426 | Wellspan Medical Group | Pain Medicine | 140 Pine Grove Commons, York, PA 17403-5151 | 2006-10-04 |
1194819193 | Wellspan Medical Group | Neurological Surgery | 228 Saint Charles Way, York, PA 17402-4644 | 2006-10-03 |
1740236900 | Wellspan Medical Group | Orthopaedic Surgery | 18 Deatrick Drive, Gettysburg, PA 17325-6958 | 2006-05-26 |
1215994934 | Wellspan Medical Group | Family Medicine | 924 Colonial Ave Ste B, York, PA 17403-3450 | 2006-04-27 |
Street Address |
40 V TWIN DR SUITE 104 |
City | GETTYSBURG |
State | PA |
Zip Code | 17325-7878 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1003800053 | Segun Toyin Dawodu | Physical Medicine & Rehabilitation | 40 V Twin Dr, Suite 205, Gettysburg, PA 17325-7875 | 2005-09-06 |
1427687599 | Julie R Knouse | Speech-Language Pathologist | 40 V Twin Dr, Gettysburg, PA 17325-7875 | 2020-04-02 |
1346879400 | Jennifer Haines | Physical Therapist | 40 V Twin Dr, Gettysburg, PA 17325-7875 | 2020-04-02 |
1871036509 | Amanda Caples | Massage Therapist | 40 V Twin Dr, Ste 205, Rm 2512, Gettysburg, PA 17325-7875 | 2016-11-29 |
1649720228 | Jennifer Ann Bishop | Registered Nurse | 40 V Twin Dr, Suite 204, Gettysburg, PA 17325-7875 | 2016-10-07 |
1134675002 | Rosalind Flickinger | Massage Therapist | 40 V Twin Dr, Ste 205, Gettysburg, PA 17325-7875 | 2016-08-30 |
1124496948 | Jennifer Wagman | Massage Therapist | 40 V Twin Dr, Suite 205 Room 2512, Gettysburg, PA 17325-7875 | 2015-09-10 |
1902274822 | Karen C Grier | Nurse Practitioner | 40 V Twin Dr, Ste 205, Gettysburg, PA 17325-7875 | 2015-09-09 |
1215305453 | Luisa Jeanne Kenny | Nurse Practitioner | 40 V Twin Dr, Gettysburg, PA 17325-7875 | 2015-09-03 |
1639422363 | Kara Renee Flickinger | Nurse Practitioner | 40 V Twin Dr, Suite 104, Gettysburg, PA 17325-7875 | 2012-10-18 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1427684059 | Health Care Center LLC | Clinic/Center | 16e Hanover Street, Hanover St, Gettysburg, PA 17325 | 2020-03-16 |
1578039574 | Cpmoptometry LLC | Point of Service | Walmart Vision, 3271 Pa 940, Mt Pocono, PA 17325 | 2018-10-17 |
1306353933 | Hayley Michelle Kidd | Physical Therapist | 237 Savannah Dr, Gettysburg, PA 17325 | 2018-01-04 |
1700247582 | Renee Lehman LLC | Physical Therapist | 249 B York Street, Gettysburg, PA 17325 | 2016-03-08 |
1245664820 | Kera Joan Provost | Pharmacist | 40 V-twin Drive, Suite 107, Gettysburg, PA 17325 | 2013-08-30 |
1790922524 | Shannon Shutika | Physical Therapist | 867 York Road, Gettysburg, PA 17325 | 2009-01-15 |
1245489988 | Edward Mitchell O'brien | Acupuncturist | 2311 Fairfield Rd., Suite E, Gettysburg, PA 17325 | 2008-09-18 |
1184882011 | The Gettysburg Hospital-short Procedure | Clinic/Center | 450 South Washington St, Suite A, Gettysburg, PA 17325 | 2008-05-28 |
1619196227 | Susquehanna Optical Inc | Eyewear Supplier (Equipment, not the service) | 506 W. Middle St., Gettysburg, PA 17325 | 2007-04-24 |
1164542437 | John Martin Fidler | Prosthetic/Orthotic Supplier | 26 Baltimore St, Gettysburg, PA 17325 | 2007-03-30 |
Find all providers in zip 17325 |
Taxonomy Code | 207RH0003X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Internal Medicine |
Specialization | Hematology & Oncology |
An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. |
Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: definiton added, source added; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1427217645 | Uzoma Nwakuche | Internal Medicine | 40 V Twin Dr Ste 104, Gettysburg, PA 17325-7878 | 2008-06-03 |
1295794519 | Douglas Roscoe Jones | Internal Medicine | 20 Expedition Trail Suite 101, Satish A. Shah, M.d., P.C., Gettysburg, PA 17325-8394 | 2006-03-23 |
1295738334 | Howard Ira Saiontz | Internal Medicine | 20 Expedition Trl, Suite 101, Gettysburg, PA 17325-8598 | 2005-05-23 |
1730338112 | Tina Ashley Khair | Internal Medicine | 20 Expedition Trl, Suite 101, Gettysburg, PA 17325-8598 | 2008-09-10 |
1851564207 | Ikechukwu Immanuel Akunyili | Internal Medicine | 40 V Twin Dr, Suite 104, Gettysburg, PA 17325-7875 | 2008-04-07 |
1235262569 | Raymond Butler Weiss | Internal Medicine | 20 Expedition Trail, Suite 101, Gettysburg, PA 17325 | 2007-03-14 |
1982734976 | Satish A. Shah, M.d., P.C. | Internal Medicine | 20 Expedition Trail, Suite 101, Gettysburg, PA 17325 | 2007-03-07 |
1487679593 | Satish A Shah | Internal Medicine | 20 Expedition Trl, Suite 101, Gettysburg, PA 17325-8598 | 2006-07-12 |
1699720136 | Robert Lamar Rice | Internal Medicine | 40 V Twin Dr, Suite 104, Gettysburg, PA 17325-7875 | 2006-05-23 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1598372286 | Bethanie Jones | Internal Medicine | 200 St Lukes Ln Ste 100, Stroudsburg, PA 18360-6218 | 2020-09-26 |
1053930362 | Dubois Regional Medical Center | Internal Medicine | 88 Hospital Rd, Brookville, PA 15825-1368 | 2020-04-16 |
1760947840 | Russell Eugene Kaufman | Internal Medicine | 700 Glengarry Rd, Philadelphia, PA 19118-4111 | 2019-02-04 |
1891204921 | Ahmed Mostafa | Internal Medicine | Hahnemann University Hospital, 230 N. Broad St., Philadelphia, PA 19102 | 2017-09-20 |
1730607755 | Penn State Health Community Medical Group, LLC | Internal Medicine | 233 College Ave Ste 303, Lancaster, PA 17603-3384 | 2017-08-30 |
1831619097 | Pinnacle Health Regional Physicians | Internal Medicine | 233 College Ave Ste 100, Lancaster, PA 17603-3372 | 2017-06-20 |
1194193656 | Allen Oliff | Internal Medicine | 1412 Florence Dr, Gwynedd Valley, PA 19437 | 2015-09-14 |
1679958912 | Lancaster Medical Group, LLC | Internal Medicine | 1575 Highlands Dr Ste 205, Lititz, PA 17543-7507 | 2015-07-28 |
1780077735 | Arnon I Dreyfuss | Internal Medicine | 239 Delancey St, Philadelphia, PA 19106-4318 | 2015-03-16 |
1164841193 | Maria Vershvovsky | Internal Medicine | 440 E Marshall St Ste 101, West Chester, PA 19380-5414 | 2014-04-07 |
Find all providers with the same taxonomy |
City | GETTYSBURG |
Zip Code | 17325 |
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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.