Individual provider Active NPI

Jonelle R Derk, CRNP

  • Family Nurse Practitioner
  • Harrisburg, PA
National Provider Identifier
1003487992
Registry record updated Jul 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP023959 Issued in PA
Practice address
111 S Front St
Harrisburg, PA 17101-2010
Phone
(717) 782-3380
Fax
(717) 782-5716
NPI assigned
Jul 2, 2021
Last updated
Jul 14, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X SP023959 PA Primary
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 1

TypeEndpointUseAffiliation
Direct Messaging Address jderk205587@phsdirect.pinnaclehealth.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210727001711 PA Practitioner - Nurse Practitioner 3375946437 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pinnacle Health Observation Services LLCGroup PAC ID 9537481528, 23 clinicians

Practice addresses (Care Compare)

111 S Front St
Harrisburg, PA 17101-2010
Phone (717) 782-3380

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
SP023959PAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pinnacle Health Observation Services LLC Nurse Practitioner CurrentSince Jul 1, 2023 Accepting new patients
Pinnacle Health Cardiovascular Institute Inc Nurse Practitioner CurrentSince Jul 1, 2021 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

  • Direct secure messaging: jderk205587@phsdirect.pinnaclehealth.org
  • Direct secure messaging: jderk285538@upmc.direct-ci.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "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

Sources for this page

Verify at the official NPI Registry.