Individual provider Active NPI

Taylor Renee Showers, CRNP, DNP

  • Nurse Practitioner
  • Selinsgrove, PA
National Provider Identifier
1023850559
Registry record updated Sep 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
SP030298 Issued in PA
Practice address
21 Susquehanna Valley Mall Dr Ste a
Selinsgrove, PA 17870-9148
Phone
(570) 374-7852
Fax
(570) 374-7932
NPI assigned
Jun 6, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 24, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered NurseGroup: 193200000X MULTI-SPECIALTY GROUP 163W00000X RN707186 PA
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X SP030298 PA Primary

Addresses

Primary practice location

21 Susquehanna Valley Mall Dr Ste a
Selinsgrove, PA 17870-9148

Mailing address

7 Dock Hill Rd
Middleburg, PA 17842-8910
Phone (570) 837-2123

Other identifiers 2

IdentifierTypeStateIssuer
6W5238OtherPAMEDICARE
1043765800001MedicaidPA

Other names 1

  • Taylor Renee Dietrich Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address taylorshowerscrnp@fpc.medentdirect.com Health Information Exchange (HIE) FAMILY PRACTICE CENTER, PC

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
I20240827001451 PA Practitioner - Nurse Practitioner 9436698081 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Family Practice Center PCGroup PAC ID 0244124212, 351 clinicians

Practice addresses (Care Compare)

21 Susquehanna Valley Mall Dr
Suite a
Selinsgrove, PA 17870-9148
Phone (570) 374-7852

Hospital & facility affiliations

  • Wellspan Evangelical Community Hospital Hospital, Lewisburg, PA, CCN 390013

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN707186PAMDRegistered Nurse
SP030298PAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Family Practice Center, PC CurrentSince Sep 1, 2024 Accepting new patients
Family Practice Center, PC Multi-Specialty CurrentSince Sep 1, 2024 Accepting new patients

Locations

7 Dock Hill Rd
Middleburg, PA 17842
Phone (570) 837-2123

21 Susquehanna Valley Mall Dr
Ste A
Selinsgrove, PA 17870
Phone (570) 374-7852

270 Susquehanna Valley Mall Dr
Ste 300
Selinsgrove, PA 17870
Phone (570) 743-1703

Interoperability endpoints

  • Direct secure messaging: taylorshowerscrnp@fpc.medentdirect.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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1717632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727136000000",
    "number": "1023850559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 DOCK HILL RD",
            "city": "MIDDLEBURG",
            "state": "PA",
            "postal_code": "178428910",
            "telephone_number": "570-837-2123",
            "fax_number": "570-837-2185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 SUSQUEHANNA VALLEY MALL DR STE A",
            "city": "SELINSGROVE",
            "state": "PA",
            "postal_code": "178709148",
            "telephone_number": "570-374-7852",
            "fax_number": "570-374-7932"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHOWERS",
        "first_name": "TAYLOR",
        "middle_name": "RENEE",
        "credential": "CRNP, DNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-06-06",
        "last_updated": "2024-09-24",
        "certification_date": "2024-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse",
            "state": "PA",
            "license": "RN707186",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "SP030298",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "6W5238",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1043765800001",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "taylorshowerscrnp@fpc.medentdirect.com",
            "affiliation": "Y",
            "affiliationName": "FAMILY PRACTICE CENTER, PC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "21 Susquehanna Valley Mall Dr Ste A",
            "city": "Selinsgrove",
            "state": "PA",
            "country_code": "US",
            "postal_code": "178709148",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "TAYLOR",
            "last_name": "DIETRICH",
            "middle_name": "RENEE",
            "credential": "CRNP, DNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Selinsgrove, PA

Sources for this page

Verify at the official NPI Registry.