Individual provider Active NPI

Christy Gazdziak, FNP-BC

  • Nurse Practitioner
  • Lebanon, PA
National Provider Identifier
1255972071
Registry record updated May 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
SP027931 Issued in PA
Practice address
900 Tuck St
Lebanon, PA 17042-7446
Phone
(717) 273-8595
Fax
(717) 273-2065
NPI assigned
Oct 2, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2024

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 162109 GA
Nurse Practitioner 363L00000X SP027931 PA Primary

Addresses

Primary practice location

900 Tuck St
Lebanon, PA 17042-7446

Mailing address

900 Tuck St
Lebanon, PA 17042-7446
Phone (717) 273-8595

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, PA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20200817003114 GA Practitioner - Nurse Practitioner 4486070737
I20230901003329 PA Practitioner - Nurse Practitioner 4486070737 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing

Practice roles

OrganizationSpecialtyStatusNew patients
Mid-South Home Care Services, LLC Current Accepting new patients
Ih Physician Services PC Current Accepting new patients
Ih Physician Services, PC CurrentSince Jan 30, 2025 Accepting new patients
Ih Physician Services PC CurrentSince Jan 30, 2025 Accepting new patients
Lanier Hospice LLC PastSince Jun 14, 2021 Accepting new patients

Locations

655 Brawley School Rd
Ste 200
Mooresville, NC 28117

2090 Linglestown Rd
Ste 202
Harrisburg, PA 17110
Phone (717) 265-8883

750 Holiday Dr
Ste 110
Pittsburgh, PA 15220
Phone (412) 503-9842

Organizations & group practices 5

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": "1569974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714953600000",
    "number": "1255972071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 TUCK ST",
            "city": "LEBANON",
            "state": "PA",
            "postal_code": "170427446",
            "telephone_number": "717-273-8595",
            "fax_number": "717-273-2065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 TUCK ST",
            "city": "LEBANON",
            "state": "PA",
            "postal_code": "170427446",
            "telephone_number": "717-273-8595",
            "fax_number": "717-273-2065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAZDZIAK",
        "first_name": "CHRISTY",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-02",
        "last_updated": "2024-05-06",
        "certification_date": "2024-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "162109",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "SP027931",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, PA

Sources for this page

Verify at the official NPI Registry.