Active NPI
Elizabeth A Decicco, R.N. M.S.N.
- Nurse Practitioner
- Kittanning, PA
National Provider Identifier
1467501205
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- SP011225
- Practice address
- 300 S Jefferson St
Kittanning, PA 16201-2416 - Phone
- (724) 543-2941
- Fax
- (724) 543-4177
- NPI assigned
- Jan 10, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Registered Nurse | 163WP0808X | RN189666L | PA | |
| Nurse Practitioner | 363L00000X | SP011225 | PA | Primary |
Addresses
Primary practice location
300 S Jefferson St
Kittanning, PA 16201-2416
Mailing address
111 Hazel LN
Suite 300
Sewickley, PA 15143-1253
Phone (412) 749-7613
Other practice location 1
321 State Route 66
Leechburg, PA 15656-8279
Phone (724) 845-6755
Other practice location 2
111 Hazel Lane
Suite 300
Sewickley, PA 15143-1253
Phone (412) 749-7330
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine, Master of Science - Nursing, Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN189666L | PA | MD | Psychiatric/Mental Health Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168387200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1540944000000",
"number": "1467501205",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "111 HAZEL LN",
"address_2": "SUITE 300",
"city": "SEWICKLEY",
"state": "PA",
"postal_code": "151431253",
"telephone_number": "412-749-7613"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 S JEFFERSON ST",
"city": "KITTANNING",
"state": "PA",
"postal_code": "162012416",
"telephone_number": "724-543-2941",
"fax_number": "724-543-4177"
}
],
"practiceLocations": [
{
"address_1": "321 State Route 66",
"address_purpose": "LOCATION",
"city": "Leechburg",
"state": "PA",
"postal_code": "156568279",
"country_code": "US",
"telephone_number": "724-845-6755",
"fax_number": "724-845-6150",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "111 Hazel Lane",
"address_2": "Suite 300",
"address_purpose": "LOCATION",
"city": "Sewickley",
"state": "PA",
"postal_code": "151431253",
"country_code": "US",
"telephone_number": "412-749-7330",
"fax_number": "412-749-6764",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DECICCO",
"first_name": "ELIZABETH",
"middle_name": "A",
"credential": "R.N. M.S.N.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-10",
"last_updated": "2018-10-31",
"status": "A"
},
"taxonomies": [
{
"code": "163WP0808X",
"taxonomy_group": "",
"desc": "Registered Nurse, Psychiatric/Mental Health",
"state": "PA",
"license": "RN189666L",
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "PA",
"license": "SP011225",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kittanning, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.