Individual provider Active NPI

Jennifer Gill, CRNP

  • Adult Health Nurse Practitioner
  • Wynnewood, PA
National Provider Identifier
1558784124
Registry record updated Nov 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
SP016817 Issued in PA
Practice address
100 E Lancaster Ave Ste 330
Wynnewood, PA 19096-3443
Phone
(610) 645-6555
Fax
(610) 649-4744
NPI assigned
Feb 1, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 12, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X SP016817 PA Primary

Addresses

Primary practice location

100 E Lancaster Ave Ste 330
Wynnewood, PA 19096-3443

Mailing address

100 E Lancaster Ave Ste 330
Wynnewood, PA 19096-3443
Phone (610) 645-6555

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
I20170817000285 PA Practitioner - Nurse Practitioner 6608148234 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Penn-Medical GroupGroup PAC ID 6204730955, 3,433 clinicians

Practice addresses (Care Compare)

440 E Marshall St
101 Hem Onc West Chester
West Chester, PA 19380-5415
Phone (610) 738-2500

Hospital & facility affiliations

  • Chester County Hospital Hospital, West Chester, PA, CCN 390179
  • Paoli Hospital Hospital, Paoli, PA, CCN 390153
  • Hospital of Univ of Pennsylvania Hospital, Philadelphia, PA, CCN 390111
  • Main Line Hospital Lankenau Hospital, Wynnewood, PA, CCN 390195
  • Bryn Mawr Hospital Hospital, Bryn Mawr, PA, CCN 390139

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
SP016817PAMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Main Line Healthcare CurrentSince Aug 27, 2018 Accepting new patients
University of Penn-Medical Group CurrentSince Jun 20, 2017 Accepting new patients
University of Penn-Medical Group CurrentSince Jun 20, 2017 Accepting new patients
Paoli Hematology-Oncology Associates PC CurrentSince Oct 16, 2023 Accepting new patients

Locations

830 Old Lancaster Rd
Ste 108
Bryn Mawr, PA 19010
Phone (610) 520-5200

2 Industrial Blvd
Ste 110
Paoli, PA 19301
Phone (610) 725-0650

3400 Civic Center Blvd
#2
Philadelphia, PA 19104
Phone (215) 615-0063

3400 Civic Center Blvd
Fl 2
Philadelphia, PA 19104

440 E Marshall St
Ste 101
West Chester, PA 19380
Phone (610) 738-2500

306 E Lancaster Ave
Ste 400
Wynnewood, PA 19096
Phone (484) 476-7222

100 E Lancaster Ave
Ste 330
Wynnewood, PA 19096
Phone (610) 645-6555

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.

Hospital & facility affiliations 6

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

NPI Registry JSON

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

{
    "created_epoch": "1391212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541980800000",
    "number": "1558784124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E LANCASTER AVE STE 330",
            "city": "WYNNEWOOD",
            "state": "PA",
            "postal_code": "190963443",
            "telephone_number": "610-645-6555",
            "fax_number": "610-649-4744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E LANCASTER AVE STE 330",
            "city": "WYNNEWOOD",
            "state": "PA",
            "postal_code": "190963443",
            "telephone_number": "610-645-6555",
            "fax_number": "610-649-4744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILL",
        "first_name": "JENNIFER",
        "credential": "CRNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-02-01",
        "last_updated": "2018-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "PA",
            "license": "SP016817",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wynnewood, PA

Sources for this page

Verify at the official NPI Registry.