Active NPI
Mary Whipple
- Family Nurse Practitioner
- Erie, PA
National Provider Identifier
1407234859
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- SP014509
- Practice address
- 149 W 22ND St
Erie, PA 16502-2804 - Phone
- (814) 456-5433
- NPI assigned
- May 18, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | SP014509 | PA | Primary |
Addresses
Primary practice location
149 W 22ND St
Erie, PA 16502-2804
Mailing address
149 W 22ND St
Erie, PA 16502-2804
Phone (814) 456-5433
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| SP014509 | Other | PA | COMMONWEALTH OF PENNSYLVANIA BUREAU OF PROFESSIONAL AND OCCUPATIONAL AFFAIRS |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160126001380 | PA | Order and Referring Only - Nurse Practitioner | 5193028108 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SP014509 | PA | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1431907200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1431907200000",
"number": "1407234859",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "149 W 22ND ST",
"city": "ERIE",
"state": "PA",
"postal_code": "165022804",
"telephone_number": "814-456-5433"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "149 W 22ND ST",
"city": "ERIE",
"state": "PA",
"postal_code": "165022804",
"telephone_number": "814-456-5433"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WHIPPLE",
"first_name": "MARY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-05-18",
"last_updated": "2015-05-18",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "PA",
"license": "SP014509",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "COMMONWEALTH OF PENNSYLVANIA BUREAU OF PROFESSIONAL AND OCCUPATIONAL AFFAIRS",
"identifier": "SP014509",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Erie, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2015; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.