Individual provider Active NPI

Mary M. Weisbrod, CNM

  • Advanced Practice Midwife
  • Lewistown, PA
National Provider Identifier
1265486377
Registry record updated Aug 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
MW008563L Issued in PA
Practice address
400 Highland Ave
Lewistown, PA 17044-1167
Phone
(717) 242-4200
Fax
(717) 242-4212
NPI assigned
May 22, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X MW008563L PA Primary

Addresses

Primary practice location

400 Highland Ave
Lewistown, PA 17044-1167

Mailing address

100 N Academy Ave
Danville, PA 17822-3034
Phone (570) 271-6144

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mweisbrod27359@direct.geisinger.edu Direct

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
I20060411000435 PA Practitioner - Certified Nurse Midwife (CNM) 1951310424 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Evangelical Medical Services Organization CurrentSince Jun 19, 2019 Accepting new patients
Geisinger Clinic Current Accepting new patients
Evangelical Medical Services Organization CurrentSince Jun 19, 2019 Accepting new patients
Geisinger Clinic CurrentSince Mar 1, 2006 Accepting new patients
Guthrie Medical Group, P.C. Current Accepting new patients
Guthrie Medical Group, P.C. CurrentSince Jun 19, 2023 Accepting new patients
Guthrie Medical Group, P.C. CurrentSince Jun 19, 2023 Accepting new patients
Geisinger Clinic CurrentSince Mar 1, 2006 Accepting new patients
Robert Packer Hospital Past Accepting new patients

Locations

100 N Academy Ave
Danville, PA 17822

25 Lystra Rogers Dr
Lewisburg, PA 17837
Phone (570) 523-3290

3 Hospital Dr
Ste 206
Lewisburg, PA 17837
Phone (570) 522-9771

400 Highland Ave
Lewistown, PA 17044
Phone (717) 242-7473

21 Geisinger Ln
Lewistown, PA 17044
Phone (717) 242-4200

1 Guthrie Sq
Sayre, PA 18840
Phone (570) 887-3106

Interoperability endpoints

  • Direct secure messaging: mweisbrod27359@direct.geisinger.edu
  • Direct secure messaging: mweisbrod185299@direct-guthrie.org

Organizations & group practices 9

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": "1148256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597968000000",
    "number": "1265486377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N ACADEMY AVE",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178223034",
            "telephone_number": "570-271-6144",
            "fax_number": "570-271-6578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 HIGHLAND AVE",
            "city": "LEWISTOWN",
            "state": "PA",
            "postal_code": "170441167",
            "telephone_number": "717-242-4200",
            "fax_number": "717-242-4212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEISBROD",
        "first_name": "MARY",
        "middle_name": "M.",
        "name_prefix": "Ms.",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-22",
        "last_updated": "2020-08-21",
        "certification_date": "2020-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "PA",
            "license": "MW008563L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mweisbrod27359@direct.geisinger.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "400 Highland Ave",
            "city": "Lewistown",
            "state": "PA",
            "country_code": "US",
            "postal_code": "170441167",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lewistown, PA

Sources for this page

Verify at the official NPI Registry.