Individual provider Active NPI

Nancy Gasper, CPNP

  • Pediatric Nurse Practitioner
  • Westlake, OH
National Provider Identifier
1083679633
Registry record updated Dec 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
04854-RX Issued in OH
Practice address
2001 Crocker Rd
Suite 600
Westlake, OH 44145-6966
Phone
(440) 871-5100
NPI assigned
Apr 18, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 04854-RX OH Primary

Addresses

Primary practice location

2001 Crocker Rd
Suite 600
Westlake, OH 44145-6966

Mailing address

9639 Taberna LN
Olmsted TWP, OH 44138-4260
Phone (440) 235-8439

Other identifiers 1

IdentifierTypeStateIssuer
2985159MedicaidOH

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)
Not enrolled
Credentials
Certified Pediatric Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
04854-RXOHMDPediatric Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1145318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1356652800000",
    "number": "1083679633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9639 TABERNA LN",
            "city": "OLMSTED TWP",
            "state": "OH",
            "postal_code": "441384260",
            "telephone_number": "440-235-8439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 CROCKER RD",
            "address_2": "SUITE 600",
            "city": "WESTLAKE",
            "state": "OH",
            "postal_code": "441456966",
            "telephone_number": "440-871-5100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GASPER",
        "first_name": "NANCY",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-18",
        "last_updated": "2012-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "OH",
            "license": "04854-RX",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2985159",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Westlake, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2012; 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.