Individual provider Active NPI

Erin C Henry, CRNP

  • Acute Care Nurse Practitioner
  • Philadelphia, PA
National Provider Identifier
1447661632
Registry record updated Aug 8, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
SP007190 Issued in PA
Practice address
3400 Spruce St
2 Dulles
Philadelphia, PA 19104-4238
Phone
(215) 662-7320
NPI assigned
May 10, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X SP007190 PA Primary
Acute Care Nurse Practitioner 363LA2100X 26NJ00492800 NJ

Addresses

Primary practice location

3400 Spruce St
2 Dulles
Philadelphia, PA 19104-4238

Mailing address

3400 Spruce St
2 Dulles
Philadelphia, PA 19104-4238
Phone (215) 662-7320

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
I20140917001282 PA Practitioner - Nurse Practitioner 8628297017 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26NJ00492800NJMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University of Penn - Medical Group Current Accepting new patients
University of Penn-Medical Group Current Accepting new patients
University of Penn-Medical Group CurrentSince Feb 5, 2015 Accepting new patients
University of Penn-Medical Group CurrentSince Feb 5, 2015 Accepting new patients
University of Penn - Medical Group CurrentSince Oct 9, 2017 Accepting new patients

Locations

3400 Spruce St
Fl 2
Philadelphia, PA 19104
Phone (215) 662-2428

3400 Spruce St
Fl 3
Philadelphia, PA 19104

3624 Market St
Fl 2
Philadelphia, PA 19104
Phone (215) 615-3669

3400 Spruce St
#818
Philadelphia, PA 19104

Organizations & group practices 5

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": "1399680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407456000000",
    "number": "1447661632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 SPRUCE ST",
            "address_2": "2 DULLES",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044238",
            "telephone_number": "215-662-7320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 SPRUCE ST",
            "address_2": "2 DULLES",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044238",
            "telephone_number": "215-662-7320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENRY",
        "first_name": "ERIN",
        "middle_name": "C",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-10",
        "last_updated": "2014-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "PA",
            "license": "SP007190",
            "primary": true
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NJ",
            "license": "26NJ00492800",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.