Individual provider Active NPI

Deborah A Fernicola, CRNP

  • Chore Provider
  • Altoona, PA
National Provider Identifier
1225053374
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Chore ProviderTaxonomy code 372500000X
License
SP005188M Issued in PA
Practice address
2907 Pleasant Valley Blvd
Altoona, PA 16602-4305
Phone
(814) 943-8164
NPI assigned
Jul 12, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chore Provider 372500000X SP005188M PA Primary

Addresses

Primary practice location

2907 Pleasant Valley Blvd
Altoona, PA 16602-4305

Mailing address

608 Crawford Ave
Altoona, PA 16602-4823

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
SP005188MPAMDChore Provider

NPI Registry JSON

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1225053374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "608 CRAWFORD AVE",
            "city": "ALTOONA",
            "state": "PA",
            "postal_code": "166024823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2907 PLEASANT VALLEY BLVD",
            "city": "ALTOONA",
            "state": "PA",
            "postal_code": "166024305",
            "telephone_number": "814-943-8164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERNICOLA",
        "first_name": "DEBORAH",
        "middle_name": "A",
        "credential": "CRNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "372500000X",
            "taxonomy_group": "",
            "desc": "Chore Provider",
            "state": "PA",
            "license": "SP005188M",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Altoona, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.