Individual provider Active NPI

Kathryn Louise Jeziorski, CNM

  • Advanced Practice Midwife
  • Lewistown, PA
National Provider Identifier
1356884597
Registry record updated Aug 31, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
MW010421 Issued in PA
Practice address
400 Highland Ave
Lewistown, PA 17044-1167
Phone
(717) 242-4200
Fax
(717) 242-4212
NPI assigned
Nov 21, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 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 MW010421 PA Primary

Addresses

Primary practice location

400 Highland Ave
Lewistown, PA 17044-1167

Mailing address

100 N Academy Ave
Danville, PA 17822-4903
Phone (570) 271-6144

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kjeziorski141026@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
I20170307000783 PA Practitioner - Certified Nurse Midwife (CNM) 1153605399 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MW010421PAMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Geisinger Clinic CurrentSince Jan 6, 2020 Accepting new patients
Penn State Health Medical Group, LLC CurrentSince Jun 18, 2022 Accepting new patients
Geisinger Clinic CurrentSince Jan 6, 2020 Accepting new patients
Geisinger Clinic Current Accepting new patients
Penn State Health Medical Group, LLC CurrentSince Jun 18, 2022 Accepting new patients
Penn State Health Medical Group, LLC Current Accepting new patients
Geisinger Clinic PastSince Jan 9, 2017 Accepting new patients

Locations

423 N 21st St
Ste 202
Camp Hill, PA 17011
Phone (717) 763-9880

100 N Academy Ave
Danville, PA 17822

2850 Commerce Dr
Ste 200A
Harrisburg, PA 17110
Phone (717) 901-9898

1120 Cocoa Ave
Hershey, PA 17033
Phone (717) 533-4141

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

Organizations & group practices 8

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": "1479686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598832000000",
    "number": "1356884597",
    "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": "178224903",
            "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": "JEZIORSKI",
        "first_name": "KATHRYN",
        "middle_name": "LOUISE",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-21",
        "last_updated": "2020-08-31",
        "certification_date": "2020-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "PA",
            "license": "MW010421",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kjeziorski141026@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.