NPIMap

Individual provider Active NPI

Lani L Kishbaugh, CRNP

  • Adult Health Nurse Practitioner
  • Coal Township, PA
National Provider Identifier
1336496413
Registry record updated Apr 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
SP012253 Issued in PA
Practice address
4200 Hospital Rd
Coal Township, PA 17866-9668
Phone
(570) 898-9235
Fax
(570) 644-4241
NPI assigned
Aug 8, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X SP012253 PA Primary

Addresses

Primary practice location

4200 Hospital Rd
Coal Township, PA 17866-9668

Mailing address

4200 Hospital Rd
Coal Township, PA 17866-9668
Phone (570) 898-9235

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address lkishbaugh104254@direct.geisinger.edu Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121129000228 PA Practitioner - Nurse Practitioner 7517119472 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Geisinger ClinicGroup PAC ID 5395657001, 3,432 clinicians

Practice addresses (Care Compare)

100 N Academy Ave
Danville, PA 17822-9800
Phone (570) 271-6144

4200 Hospital Rd
Coal Township, PA 17866-9668
Phone (570) 644-4200

4203 Hospital Rd
Coal Township, PA 17866-9668
Phone (570) 648-4010

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Geisinger Clinic CurrentSince Oct 1, 2012 Accepting new patients
Geisinger Clinic Current Accepting new patients
Geisinger Clinic CurrentSince Oct 1, 2012 Accepting new patients
Geisinger-HM Joint Venture, LLC Past Accepting new patients
Geisinger Clinic Past Accepting new patients

Locations

549 Fair St
Bloomsburg, PA 17815
Phone (570) 387-2100

4200 Hospital Rd
Coal Township, PA 17866
Phone (570) 644-4200

100 N Academy Ave
Danville, PA 17822

1020 Thompson St
Jersey Shore, PA 17740
Phone (570) 398-0100

255 Route 220 Hwy
Muncy, PA 17756
Phone (570) 308-2600

157 Roosevelt Ave
Selinsgrove, PA 17870
Phone (570) 884-3726

1000 E Mountain Blvd
Wilkes Barre, PA 18711
Phone (570) 808-7399

Interoperability endpoints

  • Direct secure messaging: lkishbaugh104254@direct.geisinger.edu

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 and National Provider Directory roles.

Hospital & facility affiliations 26

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 26

NPI Registry JSON

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

{
    "created_epoch": "1344384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744243200000",
    "number": "1336496413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4200 HOSPITAL RD",
            "city": "COAL TOWNSHIP",
            "state": "PA",
            "postal_code": "178669668",
            "telephone_number": "570-898-9235",
            "fax_number": "570-644-4241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4200 HOSPITAL RD",
            "city": "COAL TOWNSHIP",
            "state": "PA",
            "postal_code": "178669668",
            "telephone_number": "570-898-9235",
            "fax_number": "570-644-4241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KISHBAUGH",
        "first_name": "LANI",
        "middle_name": "L",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-08",
        "last_updated": "2025-04-10",
        "certification_date": "2025-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "PA",
            "license": "SP012253",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lkishbaugh104254@direct.geisinger.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "4200 Hospital Rd",
            "city": "Coal Township",
            "state": "PA",
            "country_code": "US",
            "postal_code": "178669668",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Coal Township, PA

Sources for this page

Verify at the official NPI Registry.