Individual provider Active NPI

Zachary Ryan Nolan, CRNP

  • Family Nurse Practitioner
  • Johnstown, PA
National Provider Identifier
1407527419
Registry record updated Oct 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP024306 Issued in PA
Practice address
1415 Eisenhower Blvd
Johnstown, PA 15904-3217
Phone
(814) 615-2014
Fax
(814) 269-1318
NPI assigned
Sep 21, 2021
Last updated
Oct 30, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X SP024306 PA Primary

Addresses

Primary practice location

1415 Eisenhower Blvd
Johnstown, PA 15904-3217

Mailing address

1415 Eisenhower Blvd
Johnstown, PA 15904-3217
Phone (814) 615-2014

Other practice location 1

1100 Pike St
Huntingdon, PA 16654-0002
Phone (814) 643-6520

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
I20240720000248 PA Practitioner - Nurse Practitioner 9537605043 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
SP024306PAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lifeline Medical Center Family CurrentSince Sep 8, 2024 Accepting new patients
Curana Health of Pennsylvania PC CurrentSince Jul 10, 2024 Accepting new patients
Laurel Eye Clinic PastSince Sep 8, 2024 Accepting new patients
Windber Hospital, Inc. Past Accepting new patients

Locations

526 N Saint Cloud St
#1601
Allentown, PA 18104

220 Newry St
Hollidaysburg, PA 16648
Phone (814) 693-4000

1415 Eisenhower Blvd
Johnstown, PA 15904
Phone (814) 269-3627

1415 Eisenhower Blvd
#B
Johnstown, PA 15904
Phone (814) 266-1616

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/20067/brand/1/csg/1/fhir/r4
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1632182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730246400000",
    "number": "1407527419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1415 EISENHOWER BLVD",
            "city": "JOHNSTOWN",
            "state": "PA",
            "postal_code": "159043217",
            "telephone_number": "814-615-2014",
            "fax_number": "814-269-1318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1415 EISENHOWER BLVD",
            "city": "JOHNSTOWN",
            "state": "PA",
            "postal_code": "159043217",
            "telephone_number": "814-615-2014",
            "fax_number": "814-269-1318"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1100 Pike St",
            "address_purpose": "LOCATION",
            "city": "Huntingdon",
            "state": "PA",
            "postal_code": "166540002",
            "country_code": "US",
            "telephone_number": "814-643-6520",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NOLAN",
        "first_name": "ZACHARY",
        "middle_name": "RYAN",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-09-21",
        "last_updated": "2024-10-30",
        "certification_date": "2024-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP024306",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnstown, PA

Sources for this page

Verify at the official NPI Registry.