Individual provider Active NPI

George T Eckenrode, CNM

  • Advanced Practice Midwife
  • Lititz, PA
National Provider Identifier
1043280969
Registry record updated Jan 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
MW008165L Issued in PA
Practice address
1575 Highlands Dr
Suite 101
Lititz, PA 17543-7507
Phone
(717) 393-1338
Fax
(717) 627-1817
NPI assigned
Jan 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X MW008165L PA Primary

Addresses

Primary practice location

1575 Highlands Dr
Suite 101
Lititz, PA 17543-7507

Mailing address

409 S 2ND St Ste 2F
Harrisburg, PA 17104-1612

Other identifiers 1

IdentifierTypeStateIssuer
001442535MedicaidPA

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)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
MW008165LPAMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
OB-GYN of Lancaster, Inc Adv Nursing Prov Advanced Practice Midwife Past Accepting new patients
Central Pennsylvania Obstetrics Gynecology Inc Past Accepting new patients
OB-GYN of Lancaster Inc Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1138060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1515369600000",
    "number": "1043280969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 S 2ND ST STE 2F",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171041612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1575 HIGHLANDS DR",
            "address_2": "SUITE 101",
            "city": "LITITZ",
            "state": "PA",
            "postal_code": "175437507",
            "telephone_number": "717-393-1338",
            "fax_number": "717-627-1817"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ECKENRODE",
        "first_name": "GEORGE",
        "middle_name": "T",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-24",
        "last_updated": "2018-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "PA",
            "license": "MW008165L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001442535",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lititz, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2018; 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.