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WELLSPAN FAMILY MEDICINE-ROOSEVELT AVENUE
NPI 1881020808
Family Medicine in York, PA

Active since September 23, 2013CLIA 39D2073414 · Waiver
1401 ROOSEVELT AVE, YORK, PA 17404(717) 812-7000(717) 767-8985 Get Directions Write a Review

NPPES record last updated: January 10, 2014. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Wellspan Family Medicine-roosevelt Avenue NPPES

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

WELLSPAN FAMILY MEDICINE-ROOSEVELT AVENUE (NPI 1881020808) is a healthcare organization registered as a family medicine in York, Pennsylvania and active in the NPI registry since September 2013. The organization holds a CLIA Waiver certificate valid through June 7, 2027 and lists Amy F Wilkinson, Credentialing Supervisor, as its authorized official.

NPPES Registry Identity

NPI1881020808
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameWELLSPAN MEDICAL GROUP
Location Address1401 ROOSEVELT AVEYork, PA 17404-2244
Mailing Address1803 Mount Rose Ave Ste B3York, PA 17403-3051 · (717) 812-7000 · Fax (717) 767-8985
Phone(717) 812-7000
Fax(717) 767-8985
Organization SubpartNo
Authorized OfficialAmy F WilkinsonCredentialing Supervisor · (717) 851-1405
Enumeration DateSeptember 23, 2013
Last NPPES UpdateJanuary 10, 2014
✔ NPI 1881020808 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.
1401 ROOSEVELT AVE, York, PA 17404
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Other Names 1

Doing Business AsWellspan Family Medicine-roosevelt Avenue

Other Identifiers 1

Medicare PIN117038PA

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-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 39D2073414

Wellspan Family Medicine - Roosevelt Ave · York, PA
Active · expires Jun 7, 2027
CLIA Number39D2073414
Laboratory TypePhysician Office
Certificate Effective DateJune 8, 2025
Certificate Expiration DateJune 7, 2027
Laboratory DirectorDr. Quincy O. Harberger
Laboratory Phone(717) 812-7000
Laboratory LocationWellspan Family Medicine - Roosevelt Ave1401 Roosevelt Avenue Attn- Practice Manager, York, PA 17404
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JAIME HENSON CRNP
Nurse Practitioner (Family)
1401 ROOSEVELT AVE
YORK, PA 17404
York County (717) 356-6250
EMILY M WARNER CRNP
Nurse Practitioner (Family)
1401 ROOSEVELT AVE
YORK, PA 17404
York County (717) 812-7000
DETRICH BROWN NP
Nurse Practitioner (Family)
1401 ROOSEVELT AVE
YORK, PA 17404
York County (717) 812-7000
MRS. STEPHANIE ELIZABETH BOYER CRNP
Nurse Practitioner (Family)
1401 ROOSEVELT AVE
YORK, PA 17404
York County (717) 356-6250
DR. BRUCE EDGAR WALTHER MD
Family Medicine
1401 ROOSEVELT AVE
YORK, PA 17404
York County (717) 356-6250
DR. SARA ELIZABETH IONESCU M.D.
Family Medicine
1401 ROOSEVELT AVE
YORK, PA 17404
York County (717) 356-6250
MRS. VERONICA LYNN WEISSNER MSN, FNP-BC
Nurse Practitioner (Family)
1401 ROOSEVELT AVE
YORK, PA 17404
York County (717) 812-7000
HOLLY NADINE CARNEY
Nurse Practitioner (Family)
1401 ROOSEVELT AVE
YORK, PA 17404
York County (717) 356-6250

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 Wellspan Medical Group's NPI number?

The NPI number for Wellspan Medical Group is 1881020808. It was assigned to this organization in the NPPES registry on September 23, 2013. The provider is doing business as Wellspan Family Medicine-Roosevelt Avenue.

Where is Wellspan Medical Group located?

Wellspan Medical Group is located at 1401 Roosevelt Ave, York, PA 17404. The listed phone number is (717) 812-7000.

What is Wellspan Medical Group's specialty?

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

Does Wellspan Medical Group hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 39D2073414) is associated with this NPI, valid through June 7, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Wellspan Medical Group was last updated on January 10, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.