Individual provider Active NPI

John Enderle

  • Social Worker
  • York, PA
National Provider Identifier
1265197586
Registry record updated Nov 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Practice address
1195 Roosevelt Ave
York, PA 17404-2350
Phone
(717) 843-0800
NPI assigned
Nov 2, 2021
Last updated
Nov 2, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X NU Primary

Addresses

Primary practice location

1195 Roosevelt Ave
York, PA 17404-2350

Mailing address

625 W Elm Ave
Hanover, PA 17331-5125
Phone (717) 632-4900

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230309001982 PA Practitioner - Clinical Social Worker 2365815560 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Truenorth Wellness Services CurrentSince Feb 13, 2023 Accepting new patients
Truenorth Wellness Services CurrentSince Feb 13, 2023 Accepting new patients
Resilient Paths Counseling, LLC Current Accepting new patients
Truenorth Wellness Services Current Accepting new patients

Locations

625 W Elm Ave
Hanover, PA 17331

1195 Roosevelt Ave
York, PA 17404
Phone (717) 843-0800

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, 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": "1635811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635811200000",
    "number": "1265197586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 W ELM AVE",
            "city": "HANOVER",
            "state": "PA",
            "postal_code": "173315125",
            "telephone_number": "717-632-4900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1195 ROOSEVELT AVE",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174042350",
            "telephone_number": "717-843-0800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENDERLE",
        "first_name": "JOHN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-11-02",
        "last_updated": "2021-11-02",
        "certification_date": "2021-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in York, PA

Sources for this page

Verify at the official NPI Registry.