NPIMap

Individual provider Active NPI

Mary Ann Shultz-Viersma, CRNP

  • Gerontology Nurse Practitioner
  • Gettysburg, PA
National Provider Identifier
1427698893
Registry record updated Aug 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
SP021230 Issued in PA
Practice address
147 Gettys St
Gettysburg, PA 17325-2534
Phone
(717) 338-4525
NPI assigned
Jan 13, 2020
Last updated
Aug 29, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X SP021230 PA Primary

Addresses

Primary practice location

147 Gettys St
Gettysburg, PA 17325-2534

Mailing address

601 Memory LN
York, PA 17402-2231
Phone (717) 851-1405

Other practice location 1

40 V Twin Dr
Gettysburg, PA 17325-7875
Phone (717) 339-2424

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200203000603 PA Practitioner - Nurse Practitioner 7719313279 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Good Samaritan Physician ServicesGroup PAC ID 5496728172, 102 clinicians

Practice addresses (Care Compare)

147 Gettys St
Gettysburg, PA 17325-2534
Phone (717) 338-4525

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
SP021230PAMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Good Samaritan Physician Services CurrentSince Mar 1, 2024 Accepting new patients
Good Samaritan Physician Services CurrentSince Mar 1, 2024 Accepting new patients
Good Samaritan Physician Services Current Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

147 Gettys St
Gettysburg, PA 17325
Phone (717) 334-2121

40 V Twin Dr
Gettysburg, PA 17325
Phone (717) 339-2424

844 Tuck St
Lebanon, PA 17042
Phone (717) 274-8875

25 Monument Rd
Ste 270
York, PA 17403
Phone (717) 741-8250

601 Memory Ln
York, PA 17402
Phone (717) 851-6670

Interoperability endpoints

  • Direct secure messaging: mshultzviersma168968@wellspan.direct-ci.com

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.

Hospital & facility affiliations 6

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": "1578873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724889600000",
    "number": "1427698893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 MEMORY LN",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174022231",
            "telephone_number": "717-851-1405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "147 GETTYS ST",
            "city": "GETTYSBURG",
            "state": "PA",
            "postal_code": "173252534",
            "telephone_number": "717-338-4525"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "40 V Twin Dr",
            "address_purpose": "LOCATION",
            "city": "Gettysburg",
            "state": "PA",
            "postal_code": "173257875",
            "country_code": "US",
            "telephone_number": "717-339-2424",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHULTZ-VIERSMA",
        "first_name": "MARY",
        "middle_name": "ANN",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-13",
        "last_updated": "2024-08-29",
        "certification_date": "2024-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "PA",
            "license": "SP021230",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gettysburg, PA

Sources for this page

Verify at the official NPI Registry.