NPIMap

Individual provider Active NPI

Adriene Slacktish, CRNP

  • Adult Health Nurse Practitioner
  • Wilkes Barre, PA
National Provider Identifier
1336556588
Registry record updated Jun 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
SP013969 Issued in PA
Practice address
1000 E Mountain Blvd
Wilkes Barre, PA 18711-0027
Phone
(570) 808-5780
NPI assigned
Jul 21, 2014
Last updated
Jun 10, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 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 SP013969 PA Primary

Addresses

Primary practice location

1000 E Mountain Blvd
Wilkes Barre, PA 18711-0027

Mailing address

1000 E Mountain Blvd
Wilkes Barre, PA 18711-0027
Phone (570) 808-5780

Other names 1

  • Adriene Coyle Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address aslacktish117635@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
I20141002000971 PA Practitioner - Nurse Practitioner 5799905386 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
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

1155 E Mountain Blvd
Wilkes Barre, PA 18702-7906
Phone (570) 808-5135

1175 E Mountain Blvd
Suite 150723
Wilkes Barre, PA 18702-7906
Phone (570) 808-1093

3 W Olive St
Scranton, PA 18508-2572
Phone (570) 207-5970

950 E Mountain Blvd
Wilkes Barre, PA 18702-7924
Phone (570) 808-5770

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
SP013969PAMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Geisinger Clinic Current Accepting new patients
Geisinger Clinic CurrentSince Sep 1, 2014 Accepting new patients
Geisinger Clinic CurrentSince Sep 1, 2014 Accepting new patients
Geisinger Clinic Past Accepting new patients

Locations

100 N Academy Ave
Danville, PA 17822

Interoperability endpoints

  • Direct secure messaging: aslacktish117635@direct.geisinger.edu

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.

Hospital & facility affiliations 20

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

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1405900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749513600000",
    "number": "1336556588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 E MOUNTAIN BLVD",
            "city": "WILKES BARRE",
            "state": "PA",
            "postal_code": "187110027",
            "telephone_number": "570-808-5780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 E MOUNTAIN BLVD",
            "city": "WILKES BARRE",
            "state": "PA",
            "postal_code": "187110027",
            "telephone_number": "570-808-5780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SLACKTISH",
        "first_name": "ADRIENE",
        "credential": "CRNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-07-21",
        "last_updated": "2025-06-10",
        "certification_date": "2025-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "PA",
            "license": "SP013969",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "aslacktish117635@direct.geisinger.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1000 E Mountain Blvd",
            "city": "Wilkes Barre",
            "state": "PA",
            "country_code": "US",
            "postal_code": "187110027",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "ADRIENE",
            "last_name": "COYLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Wilkes Barre, PA

Sources for this page

Verify at the official NPI Registry.