Individual provider Active NPI

Anita Denise Charles, CRNP

  • Pediatric Nurse Practitioner
  • Hershey, PA
National Provider Identifier
1205200441
Registry record updated Dec 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
SP015686 Issued in PA
Practice address
500 University Dr
Hershey, PA 17033-2360
Phone
(717) 531-7300
NPI assigned
Nov 28, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X SP015686 PA
Pediatric Nurse Practitioner 363LP0200X SP015686 PA Primary

Addresses

Primary practice location

500 University Dr
Hershey, PA 17033-2360

Mailing address

655 Walnut St
West Reading, PA 19611-1242
Phone (717) 569-8518

Other practice location 1

1725 Oregon Pike
#100
Lancaster, PA 17601-4206
Phone (717) 569-8518

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
I20200610001845 PA Practitioner - Nurse Practitioner 5395166714 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
The Milton S Hershey Medical Center Physician Group CurrentSince Jan 30, 2023 Accepting new patients
The Milton S Hershey Medical Center Physicians Group CurrentSince Jan 30, 2023 Accepting new patients
The Milton S Hershey Medical Center Physicians Group Current Accepting new patients
The Milton S. Hershey Medical Center Physicians Group Past Accepting new patients

Locations

35 Hope Dr
Ste 104
Hershey, PA 17033
Phone (717) 531-5160

500 University Dr
#A410
Hershey, PA 17033
Phone (717) 531-8131

500 University Dr
Hershey, PA 17033
Phone (717) 531-8181

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1448668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701734400000",
    "number": "1205200441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "655 WALNUT ST",
            "city": "WEST READING",
            "state": "PA",
            "postal_code": "196111242",
            "telephone_number": "717-569-8518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 UNIVERSITY DR",
            "city": "HERSHEY",
            "state": "PA",
            "postal_code": "170332360",
            "telephone_number": "717-531-7300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1725 Oregon Pike",
            "address_2": "#100",
            "address_purpose": "LOCATION",
            "city": "Lancaster",
            "state": "PA",
            "postal_code": "176014206",
            "country_code": "US",
            "telephone_number": "717-569-8518",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHARLES",
        "first_name": "ANITA",
        "middle_name": "DENISE",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-11-28",
        "last_updated": "2023-12-05",
        "certification_date": "2023-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "SP015686",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "PA",
            "license": "SP015686",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hershey, PA

Sources for this page

Verify at the official NPI Registry.