Nelda Renee Hampton
Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Cresco, PA
NPI 1417364837 · NPPES record last updated Sep 30, 2016
Key facts
- NPI
- 1417364837
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Student in an Organized Health Care Education/Training Program 390200000X
- Practice address
- 318 Wyndham Dr
Private House
Cresco, PA 18326-7450 - Phone
- (347) 528-4316
- NPI assigned
- Jul 17, 2014
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20221201000971 | NY | Practitioner - Qualified Speech Language Pathologist | 6204204811 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 027751 | NY | MD | Physical Therapist |
| 004390-1 | NY | MD | Physical Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 004390-1 | NY | |
| Student in an Organized Health Care Education/Training Program | 390200000X | Yes |
Addresses
Primary practice location
318 Wyndham Dr
Private House
Cresco, PA 18326-7450
Mailing address
318 Wyndham Drive
Cresco, PA 18326
Phone (347) 528-4316
Other names
- Ms. Nelda Renee Hampton
Other providers in Cresco, PA
- James Corio
- Joseph Francis Dilger
- Derek Gorman
- Michelle Grassie
- Maranda Leigh Hammerstone
- Michael N. Kessler
- Phillip Everett Long
- Cheryl Ann Lynott
- Debra Sarch Matrick
- Alexis Love Monge
All providers in Cresco, PA · Student in an Organized Health Care Education/Training Program in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 30, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.