Gregory William Wesley-Lynch, CRNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

SP021654 Issued in PA

Practice address

625 Clark Ave
King of Prussia, PA 19406-1438

Phone

(215) 203-4072

NPI assigned

Mar 6, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1583452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583452800000",
    "number": "1053946319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 CLARK AVE",
            "city": "KING OF PRUSSIA",
            "state": "PA",
            "postal_code": "194061438",
            "telephone_number": "215-203-4072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 CLARK AVE",
            "city": "KING OF PRUSSIA",
            "state": "PA",
            "postal_code": "194061438",
            "telephone_number": "215-203-4072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WESLEY-LYNCH",
        "first_name": "GREGORY",
        "middle_name": "WILLIAM",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-06",
        "last_updated": "2020-03-06",
        "certification_date": "2020-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP021654",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Scott Welliver
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• Davonna L Wells
• Nicole Elaine Welton, BCBA
• Teresa K Werner, CRNA
• Justyna Westbrook, LPC, CAADC
• Jennifer Wheatly- Deetz
• Laura Nichole Wheeler, CRNP
• Paul Whelan
• Swiyah Zakirah C Whittington, LPMHC

• Family Nurse Practitioner in King of Prussia, PA
• Providers in King of Prussia, PA by specialty
• Family Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.