Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days.
Organization
WELLSPAN MEDICAL GROUP
Active
Organization
WELLSPAN MEDICAL GROUP
Active
Other names
Pine Grove Adult Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
MS. AMY F WILKINSON (CREDENTIALING COORDINATOR)
(717) 851-1405
Entity
Organization
Contact information
Practice address
300 PINE GROVE COMMONS, YORK, PA 17403-5176
(717) 812-2143
(717) 812-2163
Mailing address
1803 MOUNT ROSE AVE, SUITE B3, YORK, PA 17403-3051
(717) 851-1405
(717) 812-2163
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007721360258
—
PA
01
—
1471291
HIGHMARK BLUE SHIELD
PA
01
—
1531858
GATEWAY
PA
01
—
20022918
AMERIHEALTH MERCY
PA
01
—
2155344001
AMERIHEALTH 65 PA
PA
01
—
50023472
CAPITAL BLUE CROSS
PA
01
—
7689843
AETNA
PA
01
—
800174
JOHN HOPKINS
PA
01
—
CA3246
RAILROAD MEDICARE
PA
01
—
KX54
CAREFIRST MD BCBS
MD
01
—
S1EY
GEISINGER
PA
Enumeration date
12/06/2006
Last updated
08/11/2010
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up