Individual provider Active NPI

Rondelle Longenecker, C.R.N.P.

  • Nurse Practitioner
  • Wyomissing, PA
National Provider Identifier
1669622890
Registry record updated Jun 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
SP009795 Issued in PA
Practice address
1991 State Hill Rd
Wyomissing, PA 19610-1648
Phone
(484) 628-4270
Fax
(484) 628-4261
NPI assigned
Sep 24, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2015

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 SP009795 PA Primary

Addresses

Primary practice location

1991 State Hill Rd
Wyomissing, PA 19610-1648

Mailing address

PO Box 13579
Reading, PA 19612-3579
Phone (484) 628-0796

Other identifiers 1

IdentifierTypeStateIssuer
102201860MedicaidPA

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
I20081016000336 PA Practitioner - Nurse Practitioner 2264590470 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Reading Nephrology, LTDGroup PAC ID 2062451578, 13 clinicians

Practice addresses (Care Compare)

1030 Reed Ave
Suite 114
Wyomissing, PA 19610-2039
Phone (610) 376-7365

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
SP009795PAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Reading Nephrology, LTD CurrentSince Aug 29, 2018 Accepting new patients
Tower Health Medical Group Current Accepting new patients
Tower Health Medical Group CurrentSince Aug 10, 2008 Accepting new patients
Tower Health Medical Group CurrentSince Aug 10, 2008 Accepting new patients

Locations

301 S 7th Ave
Ste 130
West Reading, PA 19611
Phone (610) 988-4630

1991 State Hill Rd
Wyomissing, PA 19610
Phone (484) 628-4270

2610 Keiser Blvd
Wyomissing, PA 19610
Phone (484) 628-9127

220 N Park Rd
Wyomissing, PA 19610

1030 Reed Ave
Ste 114
Wyomissing, PA 19610
Phone (610) 376-7365

Interoperability endpoints

  • Direct secure messaging: rondellel@readingnephrology.medentdirect.com

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 7

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": "1222214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434585600000",
    "number": "1669622890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13579",
            "city": "READING",
            "state": "PA",
            "postal_code": "196123579",
            "telephone_number": "484-628-0796",
            "fax_number": "484-334-7026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1991 STATE HILL RD",
            "city": "WYOMISSING",
            "state": "PA",
            "postal_code": "196101648",
            "telephone_number": "484-628-4270",
            "fax_number": "484-628-4261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONGENECKER",
        "first_name": "RONDELLE",
        "credential": "C.R.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-24",
        "last_updated": "2015-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "SP009795",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102201860",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyomissing, PA

Sources for this page

Verify at the official NPI Registry.