The Fall Prevention Group, LLC

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

Legal business name

THE FALL PREVENTION GROUP, LLC

Practice address

4401 Haverford Ave # 19104
Philadelphia, PA 19104-1332

Phone

(215) 349-8800

NPI assigned

Aug 27, 2014

Last updated

Aug 27, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Deanna L. Gray-Miceli, PHD, GNP-BCNPI 1710213251

Title

Ceo/Administrator

Phone

(609) 790-2327

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Deanna Lynn Gray-Miceli, PHD., GNP-BC

  • Gerontology Nurse Practitioner
  • Marlton, NJ
  • NPI 1710213251
  Authorized official Same address or phone

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

{
    "created_epoch": "1409097600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1409097600000",
    "number": "1134529118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 N MAPLE AVE STE B1",
            "address_2": "# 284",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080539412",
            "telephone_number": "609-790-2327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4401 HAVERFORD AVE # 19104",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191041332",
            "telephone_number": "215-349-8800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE FALL PREVENTION GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-27",
        "last_updated": "2014-08-27",
        "status": "A",
        "authorized_official_last_name": "GRAY-MICELI",
        "authorized_official_first_name": "DEANNA",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "CEO/ADMINISTRATOR",
        "authorized_official_telephone_number": "609-790-2327",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD, GNP-BC"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Gerontology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Gerontology Nurse Practitioner in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Gerontology Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2014; 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.