Individual provider Active NPI

Christina Cobb, CRNP

  • Family Nurse Practitioner
  • Honesdale, PA
National Provider Identifier
1215304043
Registry record updated Jan 2, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP015219 Issued in PA
Practice address
600 Maple Ave Ste 4
Honesdale, PA 18431-1436
Phone
(570) 253-8643
NPI assigned
Aug 27, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X SP015219 PA Primary

Addresses

Primary practice location

600 Maple Ave Ste 4
Honesdale, PA 18431-1436

Mailing address

601 Park St
Honesdale, PA 18431-1445
Phone (570) 501-4000

Other identifiers 1

IdentifierTypeStateIssuer
1032024600002MedicaidPA

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
I20161018000127 PA Practitioner - Nurse Practitioner 7214225630 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
SP015219PAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wayne Memorial Hospital CurrentSince May 1, 2018 Accepting new patients
Wayne Memorial Hospital CurrentSince May 1, 2018 Accepting new patients

Locations

601 Park St
Honesdale, PA 18431
Phone (570) 253-8100

600 Maple Ave
Ste 1
Honesdale, PA 18431
Phone (570) 253-6290

601 Park St
Ste 4
Honesdale, PA 18431

600 Maple Ave
Ste 4
Honesdale, PA 18431
Phone (570) 251-6672

746 Jefferson Ave
Scranton, PA 18510
Phone (570) 340-5079

Interoperability endpoints

  • Direct secure messaging: christina.cobb.1@30200.direct.athenahealth.com

Organizations & group practices 2

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": "1440633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1514851200000",
    "number": "1215304043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 PARK ST",
            "city": "HONESDALE",
            "state": "PA",
            "postal_code": "184311445",
            "telephone_number": "570-501-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 MAPLE AVE STE 4",
            "city": "HONESDALE",
            "state": "PA",
            "postal_code": "184311436",
            "telephone_number": "570-253-8643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COBB",
        "first_name": "CHRISTINA",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-27",
        "last_updated": "2018-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP015219",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1032024600002",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Honesdale, PA

Sources for this page

Verify at the official NPI Registry.