Individual provider Active NPI

Jennifer Ganime

  • Pediatric Nurse Practitioner
  • Springfield, PA
National Provider Identifier
1316700669
Registry record updated Jul 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
SP029620 Issued in PA
Practice address
527 Baltimore Pike
Springfield, PA 19064-3839
Phone
(484) 470-6777
NPI assigned
Jan 31, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X SP029620 PA Primary

Addresses

Primary practice location

527 Baltimore Pike
Springfield, PA 19064-3839

Mailing address

3180 Fashion Center Blvd
Newark, DE 19702-3246
Phone (484) 744-0696

Other practice location 1

3180 Fashion Center Blvd
Newark, DE 19702-3246
Phone (484) 744-0696

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
SP029620PAMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
PM Pediatrics of Delaware PA Past Accepting new patients

Organizations & group practices 1

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": "1706659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722211200000",
    "number": "1316700669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3180 FASHION CENTER BLVD",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197023246",
            "telephone_number": "484-744-0696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "527 BALTIMORE PIKE",
            "city": "SPRINGFIELD",
            "state": "PA",
            "postal_code": "190643839",
            "telephone_number": "484-470-6777"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3180 Fashion Center Blvd",
            "address_purpose": "LOCATION",
            "city": "Newark",
            "state": "DE",
            "postal_code": "197023246",
            "country_code": "US",
            "telephone_number": "484-744-0696",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GANIME",
        "first_name": "JENNIFER",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-31",
        "last_updated": "2024-07-29",
        "certification_date": "2024-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "PA",
            "license": "SP029620",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2024; 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.