Individual provider Active NPI

Brooke Heiple, CRNP

  • Acute Care Nurse Practitioner
  • Johnstown, PA
National Provider Identifier
1467014050
Registry record updated Jan 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
SO020421 Issued in PA
Practice address
16 Rose Street
Johnstown, PA 15905-4327
Phone
(814) 539-0257
Fax
(814) 536-0963
NPI assigned
Jul 3, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X SP020421 PA
Primary Care Nurse Practitioner 363LP2300X SP020421 PA
Acute Care Nurse Practitioner 363LA2100X SO020421 PA Primary

Addresses

Primary practice location

16 Rose Street
Johnstown, PA 15905-4327

Mailing address

16 Rose Street
Johnstown, PA 15905-4327
Phone (814) 539-0257

Other practice location 1

104 Railroad St
Bedford, PA 15522-1013
Phone (814) 263-5804

Other identifiers 1

IdentifierTypeStateIssuer
SP020421MedicaidPA

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
I20190919001236 PA Practitioner - Nurse Practitioner 5193055028 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
SO020421PAMDAcute Care Nurse Practitioner
SP020421PAMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
DLP Conemaugh Physician Practices LLC Current Accepting new patients
DLP Conemaugh Physician Practices LLC Nurse Practitioner CurrentSince Mar 2, 2020 Accepting new patients
DLP Conemaugh Physician Practices LLC Nurse Practitioner CurrentSince Mar 2, 2020 Accepting new patients
Windber Hospital, Inc. Past Accepting new patients

Locations

1450 Scalp Ave
Ste 302
Johnstown, PA 15904
Phone (814) 262-2444

1111 Franklin St
Ste 180
Johnstown, PA 15905
Phone (814) 534-3740

1086 Franklin St
Johnstown, PA 15905
Phone (610) 250-4540

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1562112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705536000000",
    "number": "1467014050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 ROSE STREET",
            "city": "JOHNSTOWN",
            "state": "PA",
            "postal_code": "159054327",
            "telephone_number": "814-539-0257",
            "fax_number": "814-536-0963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 ROSE STREET",
            "city": "JOHNSTOWN",
            "state": "PA",
            "postal_code": "159054327",
            "telephone_number": "814-539-0257",
            "fax_number": "814-536-0963"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "104 Railroad St",
            "address_purpose": "LOCATION",
            "city": "Bedford",
            "state": "PA",
            "postal_code": "155221013",
            "country_code": "US",
            "telephone_number": "814-263-5804",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HEIPLE",
        "first_name": "BROOKE",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-03",
        "last_updated": "2024-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "SP020421",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "PA",
            "license": "SP020421",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "PA",
            "license": "SO020421",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SP020421",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnstown, PA

Sources for this page

Verify at the official NPI Registry.