1. Home
  2. Directory
  3. Pennsylvania
  4. Ephrata
  5. Family Medicine
  6. NPI Profile

WELLSPAN FAMILY MEDICINE-LAKE STREET
NPI 1346344561
Family Medicine in Ephrata, PA

Active since September 08, 2006CLIA 39D0996614 · Waiver
136 A & B LAKE STREET, EPHRATA, PA 17522(717) 721-7718(717) 721-7726 Get Directions Write a Review

NPPES record last updated: October 15, 2015. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Wellspan Family Medicine-lake Street NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

WELLSPAN FAMILY MEDICINE-LAKE STREET (NPI 1346344561) is a healthcare organization registered as a family medicine in Ephrata, Pennsylvania and active in the NPI registry since September 2006. The organization holds a CLIA Waiver certificate valid through February 21, 2028 and lists Charles David Noll, Vice President, as its authorized official.

NPPES Registry Identity

NPI1346344561
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameNORTHERN LANCASTER COUNTY MEDICAL GROUP
Location Address136 A & B LAKE STREETEphrata, PA 17522-2415
Mailing Address136 Lake StEphrata, PA 17522-2415 · (717) 721-7718 · Fax (717) 721-7726
Phone(717) 721-7718
Fax(717) 721-7726
Organization SubpartNo
Authorized OfficialCharles David NollVice President · (717) 859-5161
Enumeration DateSeptember 8, 2006
Last NPPES UpdateOctober 15, 2015
✔ NPI 1346344561 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
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.
136 A & B LAKE STREET, Ephrata, PA 17522
Open in Google Maps ↗

Other Names 1

Doing Business AsWellspan Family Medicine-lake Street

Other Identifiers 4

Medicaid1013977730008PA
Medicare PIN092914PA
Other1746343PA · Blue Shield
OtherDD6938PA · Railroad Medicare

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 39D0996614

Wellspan Family Medicine - Ephrata · Ephrata, PA
Active · expires Feb 21, 2028
CLIA Number39D0996614
Laboratory TypePhysician Office
Certificate Effective DateFebruary 22, 2026
Certificate Expiration DateFebruary 21, 2028
Laboratory DirectorPaul G. Avadanian
Laboratory Phone(717) 721-7718
Laboratory LocationWellspan Family Medicine - Ephrata446 N Reading Rd, 3rd Fl, Ephrata, PA 17522
CLIA data matches this NPI record on: Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Northern Lancaster County Medical Group's NPI number?

The NPI number for Northern Lancaster County Medical Group is 1346344561. It was assigned to this organization in the NPPES registry on September 8, 2006. The provider is doing business as Wellspan Family Medicine-Lake Street.

Where is Northern Lancaster County Medical Group located?

Northern Lancaster County Medical Group is located at 136 A & B Lake Street, Ephrata, PA 17522. The listed phone number is (717) 721-7718.

What is Northern Lancaster County Medical Group's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Does Northern Lancaster County Medical Group hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 39D0996614) is associated with this NPI, valid through February 21, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Northern Lancaster County Medical Group was last updated on October 15, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.