Basic Information
| Provider Information | |||||||||
| NPI: | 1245256080 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | JOY | ||||||||
| FirstName: | TERESA | ||||||||
| MiddleName: | M. | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 785 5TH AVE STE 3 | ||||||||
| Address2: | |||||||||
| City: | CHAMBERSBURG | ||||||||
| State: | PA | ||||||||
| PostalCode: | 172014232 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7172639555 | ||||||||
| FaxNumber: | 7177096529 | ||||||||
| Practice Location | |||||||||
| Address1: | 12 ST PAUL DR STE 203 | ||||||||
| Address2: | |||||||||
| City: | CHAMBERSBURG | ||||||||
| State: | PA | ||||||||
| PostalCode: | 172011035 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7172646511 | ||||||||
| FaxNumber: | 7172641081 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/14/2006 | ||||||||
| LastUpdateDate: | 06/18/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
| IsOrganizationSubpart: | |||||||||
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| NPICertificationDate: | 06/18/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QU0200X | N | Ambulatory Health Care Facilities | Clinic/Center | Urgent Care | 207Q00000X | OS013264 | PA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 25-1716306 | 01 | PA | SOUTH CENTRAL PREFERRED | OTHER | 6682103 | 01 | PA | AETNA HMO | OTHER | 7860132 | 01 | PA | AETNA NON-HMO | OTHER | 2148070 | 01 | PA | MAMSI | OTHER | 25-1716306 | 01 | PA | INFORMED | OTHER | 255499 | 01 | PA | UNISON | OTHER | P009161 | 01 | PA | GATEWAY | OTHER | 25-1716306 | 01 | PA | HEALTHNET/TRICARE | OTHER | P00683486 | 01 | PA | RAILROAD MEDICARE | OTHER | 25-1716306 | 01 | PA | INTERGROUP | OTHER | BJ4938114 | 01 | PA | DEA | OTHER | 25-1716306 | 01 | PA | FIRST HEALTH | OTHER | G920-0112/KDM4CU | 01 | PA | CAREFIRST | OTHER | 1245256080 | 01 | NPI | OTHER | 25-1716306 | 01 | PA | GREATWEST | OTHER | 25-1716306 | 01 | PA | MULTIPLAN/PHCS | OTHER | 50085112 | 01 | PA | CAPITAL BLUECROSS | OTHER | OS013264 | 01 | PA | LICENSE | OTHER | 102213333 0001 | 05 | PA | MEDICAID | 120420417 | 01 | PA | DEPT OF LABOR | OTHER | 25-1716306 | 01 | PA | DEVON | OTHER | 891897 | 01 | PA | HEALTH AMERICA | OTHER | JO1717292 | 01 | PA | HIGHMARK BLUE SHIELD | OTHER |