Individual provider Active NPI

Kerissa Deppe, CRNP

  • Family Nurse Practitioner
  • Bethlehem, PA
National Provider Identifier
1386072585
Registry record updated Nov 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP013297 Issued in PA
Practice address
2775 Schoenersville Rd
Bethlehem, PA 18017-7307
Phone
(610) 861-8080
Fax
(610) 861-2989
NPI assigned
Oct 24, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X SP013297 PA Primary
Nurse Practitioner 363L00000X SP013297 PA

Addresses

Primary practice location

2775 Schoenersville Rd
Bethlehem, PA 18017-7307

Mailing address

1605 N Cedar Crest Blvd Ste 411
Allentown, PA 18104-2323
Phone (484) 330-1377

Other identifiers 1

IdentifierTypeStateIssuer
SP013297OtherPASTATE LICENSE

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: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140401000154 PA Practitioner - Nurse Practitioner 6406087626 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lehigh Valley Physician GroupGroup PAC ID 3072425123, 2,512 clinicians

Practice addresses (Care Compare)

1210 S Cedar Crest Blvd
Allentown, PA 18103-6235
Phone (610) 402-3888

2775 Schoenersville Rd
Bethlehem, PA 18017-7307
Phone (610) 402-8900

3780 Hecktown Rd
Easton, PA 18045-2355
Phone (610) 333-8888

3794 Hecktown Rd
Easton, PA 18045-2355

505 Independence Rd
East Stroudsburg, PA 18301-7916
Phone (610) 402-3300

5649 Wynnewood Dr
Laurys Station, PA 18059-1124

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
SP013297PAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lehigh Valley Physician Group Nurse Practitioner Current Accepting new patients
Lehigh Valley Physician Group CurrentSince Feb 10, 2022 Accepting new patients
Lehigh Valley Physician Group CurrentSince Jan 19, 2022 Accepting new patients
Lehigh Valley Physician Group CurrentSince Jan 19, 2022 Accepting new patients
Hazleton Professional Services Nurse Practitioner CurrentSince Feb 10, 2022 Accepting new patients

Locations

2100 Mack Blvd
Fl 4
Allentown, PA 18103

2100 Mack Blvd
Allentown, PA 18103
Phone (484) 224-1892

2775 Schoenersville Rd
Bethlehem, PA 18017

1000 Alliance Dr
#10
Hazleton, PA 18202
Phone (570) 501-6450

26 Station Cir
Hazleton, PA 18202
Phone (570) 861-8710

5649 Wynnewood Dr
Ste 104
Laurys Station, PA 18059
Phone (610) 262-6641

320 W Pumping Station Rd
Quakertown, PA 18951
Phone (215) 529-4240

241 Claremont Ave
Tamaqua, PA 18252
Phone (570) 225-7211

Organizations & group practices 6

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 6

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

NPI Registry JSON

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

{
    "created_epoch": "1382572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730764800000",
    "number": "1386072585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1605 N CEDAR CREST BLVD STE 411",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181042323",
            "telephone_number": "484-330-1377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2775 SCHOENERSVILLE RD",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180177307",
            "telephone_number": "610-861-8080",
            "fax_number": "610-861-2989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEPPE",
        "first_name": "KERISSA",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-10-24",
        "last_updated": "2024-11-05",
        "certification_date": "2024-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP013297",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "SP013297",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "SP013297",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethlehem, PA

Sources for this page

Verify at the official NPI Registry.