Individual provider Active NPI

Brenda Lee Houdeshell

  • Nurse Practitioner
  • Clearfield, PA
National Provider Identifier
1487396396
Registry record updated Apr 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AG11210112 Issued in PA
Practice address
8 N Front St
Clearfield, PA 16830-2411
Phone
(814) 590-6822
NPI assigned
Apr 11, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 11, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AG11210112 PA Primary

Addresses

Primary practice location

8 N Front St
Clearfield, PA 16830-2411

Mailing address

8 N Front St
Clearfield, PA 16830-2411
Phone (814) 590-6822

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
I20230930000010 PA Practitioner - Nurse Practitioner 3971968561 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
96.6 of 100Reported as group
Promoting interoperability
96
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AG11210112PAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Dubois Regional Medical Center CurrentSince Jul 3, 2023 Accepting new patients
Dubois Regional Medical Center CurrentSince Jul 3, 2023 Accepting new patients

Locations

145 Hospital Ave
Ste 101
Dubois, PA 15801
Phone (814) 375-5305

100 Hospital Ave
Dubois, PA 15801
Phone (814) 375-2040

Organizations & group practices 2

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": "1649635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649635200000",
    "number": "1487396396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 N FRONT ST",
            "city": "CLEARFIELD",
            "state": "PA",
            "postal_code": "168302411",
            "telephone_number": "814-590-6822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 N FRONT ST",
            "city": "CLEARFIELD",
            "state": "PA",
            "postal_code": "168302411",
            "telephone_number": "814-590-6822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOUDESHELL",
        "first_name": "BRENDA",
        "middle_name": "LEE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-04-11",
        "last_updated": "2022-04-11",
        "certification_date": "2022-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "AG11210112",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clearfield, PA

Sources for this page

Verify at the official NPI Registry.