MEDICARE: JENNIFER S AMMONS M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	MD073304L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	81127 S1BX	OTHER	PA	GEISINGER HEALTH PLAN
2	964196	OTHER	PA	HIGHMARK BLUE SHIELD
3	7941403	OTHER	PA	AETNA NON-HMO
4	P002592	OTHER	PA	GATEWAY HEALTH PLAN
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	3568634	OTHER	PA	AETNA HMO
7	20027799	OTHER	PA	AMERIHEALTH MERCY HEALTH
8	P002592	OTHER	PA	HEALTH ASSURANCE
9	50015642	OTHER	PA	CAPITAL BLUE CROSS

General Provider Information

NPI Number	:	1548235716
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER S AMMONS M.D.

Provider Business Mailing Address
First Line	:	1570 FRUITVILLE PIKE
Second Line	:	ROSEVILLE PEDIATRICS
City	:	LANCASTER
State	:	PA
Zip	:	17601-4087
Country	:	US
Telephone Number	:	717-569-6481
Fax Number	:

Provider Business Practice Location Address
First Line	:	51 PETERS ROAD
Second Line	:	SUITE 202
City	:	LITITZ
State	:	PA
Zip	:	17543-7685
Country	:	US
Telephone Number	:	717-569-6481
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/21/2006
Last Update Date	:	01/23/2025

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