PENN STATE HEALTH COMMUNITY MEDICAL GROUP, LLC (NPI# 1972032761) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972032761 |
| Entity Type | Organization |
| Organization Name | PENN STATE HEALTH COMMUNITY MEDICAL GROUP, LLC |
| Practice Address |
2301 Columbia Ave Lancaster PA 17603-4154 |
| Mailing Address |
90 Hope Dr # Mca410 Hershey PA 17033-2036 |
| Practice Telephone | 7173972738 |
| Practice Fax Number | 7173977634 |
| Mailing Telephone | (717) 531-1159 |
| Mailing Fax Number | 7175310119 |
| Enumeration Date | 2017-06-06 |
| Last Update Date | 2018-03-17 |
| Authorized Official Name | STEPHEN M MASSINI (CHIEF FINANCIAL OFFICER) |
| Authorized Official Telephone | 7175318766 |
| Is Organization Subpart | Y |
| Parent Organization Name | PENN STATE HEALTH |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 133V00000X | Dietitian, Registered | Dietary & Nutritional Service Providers | ||
| N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
Allopathic & Osteopathic Physicians | ||
| N | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians | ||
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
Allopathic & Osteopathic Physicians | ||
| N | 208M00000X | Hospitalist | Allopathic & Osteopathic Physicians | ||
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1120 Cocoa Ave, Hershey, PA 170331712 | 7175334141 | 7175339797 |
| 29 Eastbrook Rd, Ronks, PA 175729769 | 7172995711 | 7172990283 |
| 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 |
| 1457824013 | Penn State Health Community Medical Group, LLC | Radiology | 4520 Union Deposit Rd, Harrisburg, PA 17111-2910 | 2019-01-07 |
| 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 |
| Street Address |
2301 COLUMBIA AVE |
| City | LANCASTER |
| State | PA |
| Zip Code | 17603-4154 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114921186 | Robert W Martin | Internal Medicine | 2301 Columbia Ave, Lancaster, PA 17603-4154 | 2005-06-08 |
| 1528547981 | Rebecca L Poole | Nurse Practitioner | 2301 Columbia Ave, Lancaster, PA 17603-4154 | 2018-08-07 |
| 1285187443 | Rebecca Crabtree | Nurse Practitioner | 2301 Columbia Ave, #1, Lancaster, PA 17603-4154 | 2016-07-25 |
| 1134447998 | Mary Elana Regan | Nurse Practitioner | 2301 Columbia Ave, Lancaster, PA 17603-4154 | 2010-05-04 |
| 1508000506 | Rebecca Anne Young | Nurse Practitioner | 2301 Columbia Ave, Lancaster, PA 17603-4154 | 2009-04-22 |
| 1164620654 | Rehabclinics Inc | Clinic/Center | 2301 Columbia Ave, Lancaster, PA 17603-4154 | 2007-07-05 |
| 1427253806 | Evelyn Sheaffer | Nurse Practitioner | 2301 Columbia Ave, Lancaster, PA 17603-4154 | 2007-06-18 |
| 1285836015 | Jennie M Barbieri | Internal Medicine | 2301 Columbia Ave, Lancaster, PA 17603-4154 | 2007-06-04 |
| 1578765301 | Michael C Manolas | Internal Medicine | 2301 Columbia Ave, Lancaster, PA 17603-4154 | 2007-06-04 |
| 1811020811 | Stephanie Todd | Internal Medicine | 2301 Columbia Ave, Lancaster, PA 17603-4154 | 2007-03-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235757311 | Meadow Grove Counseling, LLC | Counselor | 822 Marietta Avenue, Lancaster, PA 17603 | 2020-07-06 |
| 1386274355 | Bristeena K Peter | Registered Nurse | 122 Broadstone St, Lancaster, PA 17603 | 2020-01-18 |
| 1164926457 | Kelly Fickett | Registered Nurse | 100 Rohrstown Rd, Suite A, Lancaster, PA 17603 | 2018-03-21 |
| 1063929115 | Lancaster Behavioral Health Hospital LLC | Psychiatric Hospital | 333 Harrisburg Ave, Lancaster, PA 17603 | 2018-01-10 |
| 1659880458 | Young Men's Christian Association of Lancaster County | Health Educator | 265 Harrisburg Ave, Lancaster, PA 17603 | 2017-09-25 |
| 1447779228 | Joshua Michael Saez | Licensed Practical Nurse | 410 N Prince St., Lancaster, PA 17603 | 2017-09-13 |
| 1689190126 | Leeann Koch | Audiologist | 2160 Noll Drive, Suite 100, Lancaster, PA 17603 | 2017-08-16 |
| 1972950327 | T. W. Ponessa and Associates Counseling Services, Inc. | Community/Behavioral Health | 354 N. Prince Street, Suite 120, Lancaster, PA 17603 | 2016-05-16 |
| 1366804833 | Yesenia Colon Rivera | Psychologist | 812 North Prince St., Lancaster, PA 17603 | 2016-03-24 |
| 1073975959 | Laura Morse | Counselor | 48 N Queen St, Lancaster, PA 17603 | 2016-03-22 |
| Find all providers in zip 17603 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619580693 | Erica Jayne Mack | Family Medicine | 542 W Mulberry St, Lancaster, OH 43130-2907 | 2020-08-28 |
| 1134732753 | Ovp Health Care, Inc. | Family Medicine | 101 S Catawba St, Lancaster, SC 29720-2411 | 2020-08-24 |
| 1477174027 | Omnis Medical Group | Family Medicine | 401 North Ewing Street, Lancaster, OH 43130 | 2020-05-05 |
| 1134765456 | Lancaster General Medical Group | Family Medicine | 100 N Queen St Ste 200, Lancaster, PA 17603-3550 | 2019-11-21 |
| 1578116927 | Pamela Joann Jacobs | Family Medicine | 77 Westwood Rd, Lancaster, NY 14086-9522 | 2019-07-23 |
| 1730642786 | Covenantmd, LLC | Family Medicine | 930 Red Rose Ct Ste 104, Lancaster, PA 17601-1981 | 2019-04-08 |
| 1720542244 | Bryan C Benefiel, M.d. Inc. | Family Medicine | 44725 10th St W Ste 290, Lancaster, CA 93534-3049 | 2019-01-29 |
| 1154898179 | Crystal B Clark | Family Medicine | 112 Woodland Drive, Lancaster, SC 29720 | 2018-10-29 |
| 1689167751 | Jacqueline Palmer | Family Medicine | 45465 25th St E Spc 168, Lancaster, CA 93535-2392 | 2018-06-12 |
| 1154851384 | Pinnacle Health Regional Physicians | Family Medicine | 250 College Ave Ste 300, Lancaster, PA 17603-3363 | 2017-06-20 |
| Find all providers in LANCASTER | ||||
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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.