Individual provider Active NPI

Terrie Gwin, CRNP

  • Family Nurse Practitioner
  • Titusville, PA
National Provider Identifier
1396583365
Registry record updated Jul 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP030155 Issued in PA
Practice address
120 S Martin St
Titusville, PA 16354-1850
Phone
(814) 827-8400
Fax
(814) 827-8405
NPI assigned
Jul 16, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN654653 PA
Family Nurse Practitioner 363LF0000X SP030155 PA Primary

Addresses

Primary practice location

120 S Martin St
Titusville, PA 16354-1850

Mailing address

100 Shenango Ave
Sharon, PA 16146-1503
Phone (814) 827-8400

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
I20240812001710 PA Practitioner - Nurse Practitioner 4183162985 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN654653PAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Primary Health Network CurrentSince Sep 23, 2024 Accepting new patients
Primary Health Network CurrentSince Sep 23, 2024 Accepting new patients
Primary Health Network Past Accepting new patients

Locations

30 Pinnacle Dr
Clarion, PA 16214
Phone (814) 223-9900

650 East Ave
Erie, PA 16503
Phone (814) 455-5505

2000 Green St
Farrell, PA 16121
Phone (724) 342-6600

811 Grandview Rd
Ste 100
Oil City, PA 16301
Phone (814) 670-7950

63 Pitt St
Sharon, PA 16146
Phone (724) 342-6604

100 Shenango Ave
Sharon, PA 16146
Phone (724) 704-8886

120 S Martin St
Titusville, PA 16354
Phone (814) 827-2938

Interoperability endpoints

  • Direct secure messaging: terriegwin@primaryhn.medalliesdirect.net

Organizations & group practices 3

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": "1721088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722297600000",
    "number": "1396583365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 SHENANGO AVE",
            "city": "SHARON",
            "state": "PA",
            "postal_code": "161461503",
            "telephone_number": "814-827-8400",
            "fax_number": "814-827-8405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 S MARTIN ST",
            "city": "TITUSVILLE",
            "state": "PA",
            "postal_code": "163541850",
            "telephone_number": "814-827-8400",
            "fax_number": "814-827-8405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GWIN",
        "first_name": "TERRIE",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-16",
        "last_updated": "2024-07-30",
        "certification_date": "2024-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "PA",
            "license": "RN654653",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP030155",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Titusville, PA

Sources for this page

Verify at the official NPI Registry.