NPIMap

Organization Active NPI

Pear Program Inc

  • Family Nurse Practitioner
  • Wayne, PA
National Provider Identifier
1609590470
Registry record updated Sep 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
PEAR PROGRAM INC
Practice address
1010 Mount Pleasant Ave
Wayne, PA 19087-2715
Phone
(484) 969-0045
NPI assigned
Sep 26, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2022

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

Authorized official

Name
Shawn Jackson, NPNPI 1225391352
Title
Owner/Provider
Phone
(484) 969-0045

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X Primary

Addresses

Primary practice location

1010 Mount Pleasant Ave
Wayne, PA 19087-2715

Mailing address

1010 Mount Pleasant Ave
Wayne, PA 19087-2715
Phone (484) 969-0045

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, DE2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20230221000048 PA Part B Supplier - Clinic/Group Practice 0244602274 Receives reassigned benefits from 6 practitioners
Practice locations: Wayne, PA
O20241112003115 DE Part B Supplier - Clinic/Group Practice 0244602274 Receives reassigned benefits from 1 practitioner
Practice locations: Wilmington, DE

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1664150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1664150400000",
    "number": "1609590470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 MOUNT PLEASANT AVE",
            "city": "WAYNE",
            "state": "PA",
            "postal_code": "190872715",
            "telephone_number": "484-969-0045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 MOUNT PLEASANT AVE",
            "city": "WAYNE",
            "state": "PA",
            "postal_code": "190872715",
            "telephone_number": "484-969-0045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEAR PROGRAM INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-26",
        "last_updated": "2022-09-26",
        "certification_date": "2022-09-26",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "SHAWN",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "484-969-0045",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wayne, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.