Individual provider Active NPI

Wanni Lin, CRNP

  • Nurse Practitioner
  • Hershey, PA
National Provider Identifier
1396430831
Registry record updated Jul 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
SP027679 Issued in PA
Practice address
75 E Derry Rd
Hershey, PA 17033-2705
Phone
(717) 835-0700
Fax
(717) 835-0702
NPI assigned
Apr 10, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 20, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered NurseGroup: 193200000X MULTI-SPECIALTY GROUP 163W00000X RN714958 PA
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X SP027679 PA Primary

Addresses

Primary practice location

75 E Derry Rd
Hershey, PA 17033-2705

Mailing address

7 Dock Hill Rd
Middleburg, PA 17842-8910
Phone (570) 837-2123

Other identifiers 1

IdentifierTypeStateIssuer
1041873030001MedicaidPA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address wannilincrnp@fpc.medentdirect.com Health Information Exchange (HIE) FAMILY PRACTICE CENTER, PC

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
I20230810004076 PA Practitioner - Nurse Practitioner 3678935418 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Family Practice Center PCGroup PAC ID 0244124212, 351 clinicians

Practice addresses (Care Compare)

75 E Derry Rd
Hershey, PA 17033-2705
Phone (717) 835-0700

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN714958PAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Family Practice Center, PC Multi-Specialty CurrentSince Aug 1, 2023 Accepting new patients
Family Practice Center, PC CurrentSince Aug 1, 2023 Accepting new patients

Locations

300 Maytown Rd
Elizabethtown, PA 17022
Phone (717) 299-3077

75 E Derry Rd
Hershey, PA 17033
Phone (717) 298-6245

7 Dock Hill Rd
Middleburg, PA 17842
Phone (570) 837-2123

270 Susquehanna Valley Mall Dr
Ste 300
Selinsgrove, PA 17870
Phone (570) 743-1703

Interoperability endpoints

  • Direct secure messaging: wannilincrnp@fpc.medentdirect.com

Organizations & group practices 2

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 1

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": "1681084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689811200000",
    "number": "1396430831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 DOCK HILL RD",
            "city": "MIDDLEBURG",
            "state": "PA",
            "postal_code": "178428910",
            "telephone_number": "570-837-2123",
            "fax_number": "570-837-2185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 E DERRY RD",
            "city": "HERSHEY",
            "state": "PA",
            "postal_code": "170332705",
            "telephone_number": "717-835-0700",
            "fax_number": "717-835-0702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIN",
        "first_name": "WANNI",
        "credential": "CRNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-04-10",
        "last_updated": "2023-07-20",
        "certification_date": "2023-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse",
            "state": "PA",
            "license": "RN714958",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "SP027679",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1041873030001",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "wannilincrnp@fpc.medentdirect.com",
            "affiliation": "Y",
            "affiliationName": "FAMILY PRACTICE CENTER, PC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "75 E Derry Rd",
            "city": "Hershey",
            "state": "PA",
            "country_code": "US",
            "postal_code": "170332705",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hershey, PA

Sources for this page

Verify at the official NPI Registry.