Active NPI
Jacquelyn Lauren Oswald
- Pediatric Nurse Practitioner
- Philadelphia, PA
National Provider Identifier
1114687068
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- SP025053
- Practice address
- 3401 Civic Center Blvd
Philadelphia, PA 19104-4319 - Phone
- (215) 590-1000
- NPI assigned
- Dec 20, 2021
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | SP025053 | PA | Primary |
Addresses
Primary practice location
3401 Civic Center Blvd
Philadelphia, PA 19104-4319
Mailing address
2840 Haverford Rd
Ardmore, PA 19003-1715
Phone (215) 479-5466
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SP025053 | PA | MD | Pediatric Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Childrens Health Care Associates, Inc | Current | Accepting new patients | |
| Childrens Health Care Associates, Inc | Current | Accepting new patients | |
| Childen'S Health Care Associates Inc. | Current | Accepting new patients |
Locations
100 E Penn Sq
Fl 9
Philadelphia, PA 19107
Phone (267) 425-9232
3401 Civic Center Blvd
Philadelphia, PA 19104
Phone (215) 590-4040
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.
-
- Pediatrics Physician
- Philadelphia, PA
- NPI 1598869059
-
- Pediatric Registered Nurse
- Philadelphia, PA
- NPI 1699860643
-
- Pediatric Cardiology Physician
- Philadelphia, PA
- NPI 1639264682
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1639958400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1639958400000",
"number": "1114687068",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2840 HAVERFORD RD",
"city": "ARDMORE",
"state": "PA",
"postal_code": "190031715",
"telephone_number": "215-479-5466"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3401 CIVIC CENTER BLVD",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191044319",
"telephone_number": "215-590-1000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OSWALD",
"first_name": "JACQUELYN",
"middle_name": "LAUREN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-12-20",
"last_updated": "2021-12-20",
"certification_date": "2021-12-20",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "PA",
"license": "SP025053",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2021; 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.