Jonelle R Derk, CRNP
Individual provider Active NPI Family Nurse Practitioner · Harrisburg, PA
NPI 1003487992 · NPPES record last updated Jul 14, 2023
Key facts
- NPI
- 1003487992
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- SP023959 (PA)
- Practice address
- 111 S Front St
Harrisburg, PA 17101-2010 - Phone
- (717) 782-3380
- Fax
- (717) 782-5716
- NPI assigned
- Jul 2, 2021
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Hospital & facility affiliations 9
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Pinnacle Health Observation Services LLC
Practice addresses (Care Compare)
111 S Front St
Harrisburg, PA 17101-2010
Phone (717) 782-3380
Hospital & facility affiliations
- Upmc Carlisle
- Upmc Pinnacle Hospitals
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210727001711 | PA | Practitioner - Nurse Practitioner | 3375946437 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SP023959 | PA | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pinnacle Health Observation Services LLC | Nurse Practitioner | Current |
Accepting new patients |
| Pinnacle Health Cardiovascular Institute Inc | Nurse Practitioner | Current |
Accepting new patients |
Locations
360 Alexander Spring Rd
Carlisle, PA 17015
Phone (717) 243-6557
111 S Front St
Harrisburg, PA 17101
Phone (717) 782-3282
2808 Old Post Rd
Harrisburg, PA 17110
Phone (717) 591-7122
1000 N Front St
Wormleysburg, PA 17043
Interoperability endpoints
- jderk285538@upmc.direct-ci.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | SP023959 | PA | Yes |
| Nurse Practitioner | 363L00000X | SP023959 | PA |
Addresses
Primary practice location
111 S Front St
Harrisburg, PA 17101-2010
Mailing address
111 S Front St
Harrisburg, PA 17101-2010
Phone (717) 782-3380
Other practice location 1
2808 Old Post Rd
Harrisburg, PA 17110-3685
Phone (717) 920-4400
Other practice location 2
1000 N Front St
Wormleysburg, PA 17043-1034
Phone (717) 731-0101
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | jderk205587@phsdirect.pinnaclehealth.org |
NPI Registry JSON
{
"created_epoch": "1625184000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1689292800000",
"number": "1003487992",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "111 S FRONT ST",
"city": "HARRISBURG",
"state": "PA",
"postal_code": "171012010",
"telephone_number": "717-782-3380",
"fax_number": "717-782-5716"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "111 S FRONT ST",
"city": "HARRISBURG",
"state": "PA",
"postal_code": "171012010",
"telephone_number": "717-782-3380",
"fax_number": "717-782-5716"
}
],
"practiceLocations": [
{
"address_1": "2808 Old Post Rd",
"address_purpose": "LOCATION",
"city": "Harrisburg",
"state": "PA",
"postal_code": "171103685",
"country_code": "US",
"telephone_number": "717-920-4400",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1000 N Front St",
"address_purpose": "LOCATION",
"city": "Wormleysburg",
"state": "PA",
"postal_code": "170431034",
"country_code": "US",
"telephone_number": "717-731-0101",
"fax_number": "717-731-8359",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DERK",
"first_name": "JONELLE",
"middle_name": "R",
"credential": "CRNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-07-02",
"last_updated": "2023-07-14",
"certification_date": "2023-07-14",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "PA",
"license": "SP023959",
"primary": true
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "PA",
"license": "SP023959",
"primary": false
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "jderk205587@phsdirect.pinnaclehealth.org",
"affiliation": "N",
"address_1": "1000 N Front St",
"city": "Wormleysburg",
"state": "PA",
"country_code": "US",
"postal_code": "170431034",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Harrisburg, PA
- John F Dennis
- Dental Dreams, LLC
- Dental Professionals of Pennsylvania, PC
- Leah Deppen
- Brian Francis Deramo
- Robert Derner Jr.
- Kurstyn T Derr
- Derry Psychiatric Services, P.C.
- Derry Street Pharmacy LLC
- Desi Home Care of Pennsylvania LLC
All providers in Harrisburg, PA · Family Nurse Practitioner in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 14, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.