Individual provider Active NPI

Jacqueline Sweeney, CRNP

  • Adult Health Nurse Practitioner
  • Philadelphia, PA
National Provider Identifier
1154893303
Registry record updated Dec 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
SP019025 Issued in PA
Practice address
1331 E Wyoming Ave
Philadelphia, PA 19124-3808
Phone
(215) 537-7600
Fax
(215) 537-7618
NPI assigned
Dec 28, 2018
Last updated
Dec 28, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X SP019025 PA Primary

Addresses

Primary practice location

1331 E Wyoming Ave
Philadelphia, PA 19124-3808

Mailing address

1331 E Wyoming Ave
Phila, PA 19124-3808
Phone (215) 537-7400

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191114003221 PA Practitioner - Nurse Practitioner 6800228727 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
SP019025PAMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
City of Philadelphia CurrentSince Jun 1, 2024 Accepting new patients
HR Physician Services CurrentSince Jul 5, 2023 Accepting new patients
HR Physician Services CurrentSince Jul 5, 2023 Accepting new patients
City of Philadelphia CurrentSince Jun 1, 2024 Accepting new patients
HR Physician Services Current Accepting new patients
City of Philadelphia Current Accepting new patients

Locations

1648 Huntingdon Pike
Meadowbrook, PA 19046
Phone (215) 938-3413

1650 Huntingdon Pike
Ste 315
Meadowbrook, PA 19046
Phone (215) 947-2020

1101 Market St
Fl 10
Philadelphia, PA 19107

4400 Haverford Ave
#4
Philadelphia, PA 19104
Phone (215) 685-7600

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1545955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545955200000",
    "number": "1154893303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1331 E WYOMING AVE",
            "city": "PHILA",
            "state": "PA",
            "postal_code": "191243808",
            "telephone_number": "215-537-7400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1331 E WYOMING AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191243808",
            "telephone_number": "215-537-7600",
            "fax_number": "215-537-7618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWEENEY",
        "first_name": "JACQUELINE",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-28",
        "last_updated": "2018-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "PA",
            "license": "SP019025",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.