Active NPI
Ellen M Dyer, CRNP
- Pediatric Nurse Practitioner
- Harrisburg, PA
National Provider Identifier
1114068061
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- SP005993D
- Practice address
- 2645 N 3Rd St
Harrisburg, PA 17110-2001 - Phone
- (717) 782-6800
- Fax
- (717) 782-6801
- NPI assigned
- Feb 12, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | SP005993D | PA | |
| Pediatric Nurse Practitioner | 363LP0200X | SP005993D | PA | Primary |
Addresses
Primary practice location
2645 N 3Rd St
Harrisburg, PA 17110-2001
Mailing address
409 S 2ND St
Suite 2F
Harrisburg, PA 17104-1612
Phone (717) 782-6800
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 102666740 | Medicaid | PA |
Other names 1
- Ellen M Graybill
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | edyer6786@phsdirect.pinnaclehealth.org |
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
- Nurse Practitioner
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171238400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1607731200000",
"number": "1114068061",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "409 S 2ND ST",
"address_2": "SUITE 2F",
"city": "HARRISBURG",
"state": "PA",
"postal_code": "171041612",
"telephone_number": "717-782-6800",
"fax_number": "717-782-6801"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2645 N 3RD ST",
"city": "HARRISBURG",
"state": "PA",
"postal_code": "171102001",
"telephone_number": "717-782-6800",
"fax_number": "717-782-6801"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DYER",
"first_name": "ELLEN",
"middle_name": "M",
"credential": "CRNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-12",
"last_updated": "2020-12-12",
"certification_date": "2020-12-12",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "PA",
"license": "SP005993D",
"primary": false
},
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "PA",
"license": "SP005993D",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "102666740",
"state": "PA"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "edyer6786@phsdirect.pinnaclehealth.org",
"affiliation": "N",
"address_1": "2645 N 3rd St",
"city": "Harrisburg",
"state": "PA",
"country_code": "US",
"postal_code": "171102001",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"first_name": "ELLEN",
"last_name": "GRAYBILL",
"middle_name": "M",
"credential": "CRNP",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Harrisburg, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.