Individual provider Active NPI

Geraldine Anamege

  • Gerontology Nurse Practitioner
  • Stroudsburg, PA
National Provider Identifier
1023778032
Registry record updated Dec 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
SP024986 Issued in PA
Practice address
18 N 7TH St FL 2
Stroudsburg, PA 18360-2110
Phone
(570) 218-8700
NPI assigned
Dec 19, 2021
Last updated
Dec 19, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 19, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X SP024986 PA Primary

Addresses

Primary practice location

18 N 7TH St FL 2
Stroudsburg, PA 18360-2110

Mailing address

18 N 7TH St FL 2
Stroudsburg, PA 18360-2110
Phone (157) 021-8870

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
SP024986PAMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Destiny Empowerment House and Groups LLC Current Accepting new patients
Destiny Empowerment House and Groups LLC Current Accepting new patients
Destiny Empowerment House and Groups LLC Current Accepting new patients

Locations

18 N 7th St
Unit 2
Stroudsburg, PA 18360
Phone (570) 218-8700

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1639872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639872000000",
    "number": "1023778032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 N 7TH ST FL 2",
            "city": "STROUDSBURG",
            "state": "PA",
            "postal_code": "183602110",
            "telephone_number": "157-021-8870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 N 7TH ST FL 2",
            "city": "STROUDSBURG",
            "state": "PA",
            "postal_code": "183602110",
            "telephone_number": "570-218-8700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANAMEGE",
        "first_name": "GERALDINE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-12-19",
        "last_updated": "2021-12-19",
        "certification_date": "2021-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "PA",
            "license": "SP024986",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stroudsburg, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.