Individual provider Active NPI

Nichole S Henry, CRNP

  • Nurse Practitioner
  • Hershey, PA
National Provider Identifier
1043684434
Registry record updated Aug 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
SP015768 Issued in PA
Practice address
500 University Dr
Hershey, PA 17033-2360
Phone
(717) 531-8413
Fax
(717) 531-1533
NPI assigned
Nov 23, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Neonatal Nurse Practitioner 363LN0005X SP99999 PA
Nurse Practitioner 363L00000X SP015768 PA Primary

Addresses

Primary practice location

500 University Dr
Hershey, PA 17033-2360

Mailing address

PO Box 858
MC A410
Hershey, PA 17033-0858
Phone (800) 243-1455

Other practice location 1

1701 Innovation Dr
York, PA 17408-8815
Phone (717) 850-4040

Other identifiers 1

IdentifierTypeStateIssuer
103149237MedicaidPA

Other names 1

  • Nichole S Peffley Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address nhenry216087@phsdirect.pinnaclehealth.org Direct

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
I20160115001977 PA Practitioner - Nurse Practitioner 8628371143 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
SP99999PAMDCritical Care Neonatal Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pinnacle Health Medical Services CurrentSince Jan 12, 2022 Accepting new patients
Pinnacle Health Medical Services Current Accepting new patients
Pinnacle Health Medical Services CurrentSince Jan 12, 2022 Accepting new patients

Locations

409 S 2nd St
Ste 2F
Harrisburg, PA 17104
Phone (717) 231-8049

2501 N 3rd St
Fl 2
Harrisburg, PA 17110
Phone (717) 782-2100

1701 Innovation Dr
York, PA 17408
Phone (717) 843-8623

Interoperability endpoints

  • Direct secure messaging: nhenry290348@upmc.direct-ci.com

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": "1448236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660003200000",
    "number": "1043684434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 858",
            "address_2": "MC A410",
            "city": "HERSHEY",
            "state": "PA",
            "postal_code": "170330858",
            "telephone_number": "800-243-1455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 UNIVERSITY DR",
            "city": "HERSHEY",
            "state": "PA",
            "postal_code": "170332360",
            "telephone_number": "717-531-8413",
            "fax_number": "717-531-1533"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1701 Innovation Dr",
            "address_purpose": "LOCATION",
            "city": "York",
            "state": "PA",
            "postal_code": "174088815",
            "country_code": "US",
            "telephone_number": "717-850-4040",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HENRY",
        "first_name": "NICHOLE",
        "middle_name": "S",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-11-23",
        "last_updated": "2022-08-09",
        "certification_date": "2022-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LN0005X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal, Critical Care",
            "state": "PA",
            "license": "SP99999",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "SP015768",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103149237",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nhenry216087@phsdirect.pinnaclehealth.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1701 Innovation Dr",
            "city": "York",
            "state": "PA",
            "country_code": "US",
            "postal_code": "174088815",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "NICHOLE",
            "last_name": "PEFFLEY",
            "middle_name": "S",
            "credential": "CRNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Hershey, PA

Sources for this page

Verify at the official NPI Registry.