Alexander Ayonbo Oboro, CRNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

SP018569 Issued in PA

Practice address

7930 Nittany Valley Dr
Mill Hall, PA 17751-8805

Phone

(570) 323-6944

Fax

(570) 323-4529

NPI assigned

May 21, 2019

Last updated

May 17, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Community Services Group IncGroup PAC ID 1052201571, 32 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science, Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Community Services Group, Inc.

  • Community/Behavioral Health Agency
  • Mountville, PA
  • NPI 1265426084
  Medicare reassignment Care Compare group NPD
• Ultimate Mind Healthcare PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Bloomsburg, PA
  • NPI 1447157383
  Authorized official Same address or phone

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

{
    "created_epoch": "1558396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621209600000",
    "number": "1346807849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2703 OLD BERWICK RD APT B",
            "city": "BLOOMSBURG",
            "state": "PA",
            "postal_code": "178153240",
            "telephone_number": "215-252-6645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7930 NITTANY VALLEY DR",
            "city": "MILL HALL",
            "state": "PA",
            "postal_code": "177518805",
            "telephone_number": "570-323-6944",
            "fax_number": "570-323-4529"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "429 S Market St",
            "address_purpose": "LOCATION",
            "city": "Martinsburg",
            "state": "PA",
            "postal_code": "166621005",
            "country_code": "US",
            "telephone_number": "814-793-2104",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1000 Commerce Park Dr Ste 110",
            "address_purpose": "LOCATION",
            "city": "Williamsport",
            "state": "PA",
            "postal_code": "177015475",
            "country_code": "US",
            "telephone_number": "570-323-6944",
            "fax_number": "570-323-4529",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OBORO",
        "first_name": "ALEXANDER",
        "middle_name": "AYONBO",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-05-21",
        "last_updated": "2021-05-17",
        "certification_date": "2021-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP018569",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "PA",
            "license": "SP023456",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeffrey Moyle
• Kara Muthler, RN
• Michelle Naymick, PHARM. D.
• Kim Ngo, D.M.D.
• Valerie M Noel, LPC
• Isabel Pacheco-Guzman
• Misty L. Palmatier, LMFT
• Orlando Paris, B.S. PHARMACY
• Lauren Pauling, LPC
• Melissa Pebley, M.S.

• Family Nurse Practitioner in Mill Hall, PA
• Providers in Mill Hall, PA by specialty
• Family Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.