Individual provider Active NPI

Concetta Paradis

  • Clinical Exercise Physiologist
  • Wilkes Barre, PA
National Provider Identifier
1669102380
Registry record updated Jun 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Exercise PhysiologistTaxonomy code 224Y00000X
Practice address
1000 East Mountain Boulevard
Pearsall Heart Hospital 2ND Floor
Wilkes-Barre, PA 18702
Phone
(570) 808-6110
NPI assigned
Jun 15, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Exercise Physiologist 224Y00000X Primary

Addresses

Primary practice location

1000 East Mountain Boulevard
Pearsall Heart Hospital 2ND Floor
Wilkes-Barre, PA 18702

Mailing address

930 Main St.
Avoca, PA 18641
Phone (570) 574-2368

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cpparadis@geisinger.edu Direct

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)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1655251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655251200000",
    "number": "1669102380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "930 MAIN ST.",
            "city": "AVOCA",
            "state": "PA",
            "postal_code": "18641",
            "telephone_number": "570-574-2368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 EAST MOUNTAIN BOULEVARD",
            "address_2": "PEARSALL HEART HOSPITAL 2ND FLOOR",
            "city": "WILKES-BARRE",
            "state": "PA",
            "postal_code": "18702",
            "telephone_number": "570-808-6110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARADIS",
        "first_name": "CONCETTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-15",
        "last_updated": "2022-06-15",
        "certification_date": "2022-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Y00000X",
            "taxonomy_group": "",
            "desc": "Clinical Exercise Physiologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cpparadis@geisinger.edu",
            "affiliation": "N",
            "endpointDescription": "work email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1000 East Mountain Boulevard",
            "address_2": "Pearsall Heart Hospital 2nd Floor",
            "city": "Wilkes-Barre",
            "state": "PA",
            "country_code": "US",
            "postal_code": "18702",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Wilkes Barre, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.