Individual provider Active NPI

Christie J Mecouch, CRNP

  • Pediatric Nurse Practitioner
  • Lancaster, PA
National Provider Identifier
1053064063
Registry record updated Jan 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
TP006109D Issued in PA
Practice address
2221 Noll Dr Ste 2000
Lancaster, PA 17603-7614
Phone
(717) 715-1001
Fax
(717) 431-2321
NPI assigned
Jan 31, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2022

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 SP023460 PA
Pediatric Nurse Practitioner 363LP0200X TP006109D PA Primary

Addresses

Primary practice location

2221 Noll Dr Ste 2000
Lancaster, PA 17603-7614

Mailing address

2221 Noll Dr Ste 2000
Lancaster, PA 17603-7614
Phone (717) 715-1001

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Palliative Medicine Consultants Family CurrentSince Mar 6, 2023 Accepting new patients
Choices Healthcare Past Accepting new patients

Locations

169 Martin Ave
Ephrata, PA 17522
Phone (717) 733-0311

685 Good Dr
Lancaster, PA 17601
Phone (717) 295-3900

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.

NPI Registry JSON

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

{
    "created_epoch": "1643587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643587200000",
    "number": "1053064063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2221 NOLL DR STE 2000",
            "city": "LANCASTER",
            "state": "PA",
            "postal_code": "176037614",
            "telephone_number": "717-715-1001",
            "fax_number": "717-431-2321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2221 NOLL DR STE 2000",
            "city": "LANCASTER",
            "state": "PA",
            "postal_code": "176037614",
            "telephone_number": "717-715-1001",
            "fax_number": "717-431-2321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MECOUCH",
        "first_name": "CHRISTIE",
        "middle_name": "J",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-31",
        "last_updated": "2022-01-31",
        "certification_date": "2022-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP023460",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "PA",
            "license": "TP006109D",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lancaster, PA

Sources for this page

Verify at the official NPI Registry.