Individual provider Active NPI

Jennifer Lewis Miller, CRNP

  • Family Nurse Practitioner
  • Etters, PA
National Provider Identifier
1508896010
Registry record updated Dec 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
UP004221B Issued in PA
Practice address
1790 Old Trail Rd
Etters, PA 17319-9652
Phone
(717) 938-6588
Fax
(717) 938-9601
NPI assigned
Jul 3, 2006
Sex
Female
Sole proprietor
No

Organizations & group practices 3

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.

Hospital & facility affiliations 13

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

30 Ashton Dr
Etters, PA 17319-9649

Hospital & facility affiliations

  • Wellspan York Hospital Hospital, York, PA, CCN 390046
  • Upmc Pinnacle Hospitals Hospital, Harrisburg, PA, CCN 390067
  • Penn State Health Holy Spirit Medical Center Hospital, Camp Hill, PA, CCN 390004

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.

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
I20050822001151 PA Practitioner - Nurse Practitioner 8123059953

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Wellspan Medical Group CurrentSince Dec 1, 2001 Accepting new patients
Wellspan Medical Group CurrentSince Dec 1, 2001 Accepting new patients
Wellspan Medical Group Current Accepting new patients

Locations

1790 Old Trail Rd
Ste A
Etters, PA 17319
Phone (717) 938-6588

1790 Old Trail Rd
Etters, PA 17319
Phone (717) 938-6588

212 Rosedale Dr
Manchester, PA 17345
Phone (717) 266-5623

1401 Roosevelt Ave
York, PA 17404
Phone (717) 356-6250

1803 Mount Rose Ave
Ste B3
York, PA 17403
Phone (717) 851-6816

1600 S George St
York, PA 17403
Phone (717) 848-3615

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: jmiller57864@wellspan.direct-ci.com

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X UP004221B PA Primary

Addresses

NPPES NPI Registry

Primary practice location

1790 Old Trail Rd
Etters, PA 17319-9652

Mailing address

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

Other practice location 1

1401 Roosevelt Ave
York, PA 17404-2244
Phone (717) 356-6250

Other identifiers 7

NPPES NPI Registry
IdentifierTypeStateIssuer
20019454OtherPAAMERIHEALTH MERCY-WMG
104978OtherPAJOHNS HOPKINS
1975308OtherPAHIGHMARK BLUE SHIELD
1551675OtherPAGATEWAY-WMG
50083185OtherPACAPITAL BLUE CROSS-WMG WFM
03121501OtherPACAPITAL BLUE CROSS-WMG
618687OtherMDCAREFIRST MD BCBS

Other names 1

NPPES NPI Registry
  • Ms. Jennifer Lewis Former name

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Dec 23, 2024.

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734912000000",
    "number": "1508896010",
    "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": "1790 OLD TRAIL RD",
            "city": "ETTERS",
            "state": "PA",
            "postal_code": "173199652",
            "telephone_number": "717-938-6588",
            "fax_number": "717-938-9601"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1401 Roosevelt Ave",
            "address_purpose": "LOCATION",
            "city": "York",
            "state": "PA",
            "postal_code": "174042244",
            "country_code": "US",
            "telephone_number": "717-356-6250",
            "fax_number": "717-553-1269",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILLER",
        "first_name": "JENNIFER",
        "middle_name": "LEWIS",
        "name_prefix": "Ms.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-03",
        "last_updated": "2024-12-23",
        "certification_date": "2024-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "UP004221B",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH MERCY-WMG",
            "identifier": "20019454",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JOHNS HOPKINS",
            "identifier": "104978",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "1975308",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GATEWAY-WMG",
            "identifier": "1551675",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPITAL BLUE CROSS-WMG WFM",
            "identifier": "50083185",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPITAL BLUE CROSS-WMG",
            "identifier": "03121501",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST MD BCBS",
            "identifier": "618687",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "LEWIS",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Etters, PA

Sources for this page

Verify at the official NPI Registry.