Individual provider Active NPI

Mary Timm Hinkle, CRNP

  • Family Nurse Practitioner
  • Lebanon, PA
National Provider Identifier
1689695033
Registry record updated Jan 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP000820B Issued in PA
Practice address
618 Cornwall Rd Ste 2
Lebanon, PA 17042-7089
Phone
(717) 279-6700
Fax
(717) 279-6759
NPI assigned
Jul 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X SP000820B PA Primary

Addresses

Primary practice location

618 Cornwall Rd Ste 2
Lebanon, PA 17042-7089

Mailing address

3421 Concord Rd
York, PA 17402-9001
Phone (717) 279-6700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
SP000820BPAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wellspan Medical Group Current Accepting new patients
Wellspan Medical Group CurrentSince May 5, 2017 Accepting new patients
Wellspan Medical Group CurrentSince May 5, 2017 Accepting new patients

Locations

618 Cornwall Rd
Ste 2
Lebanon, PA 17042
Phone (717) 270-5449

850 Tuck St
Lebanon, PA 17042
Phone (717) 272-8173

3421 Concord Rd
York, PA 17402
Phone (717) 851-2441

25 Monument Rd
Ste 270
York, PA 17403
Phone (717) 741-8250

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.

NPI Registry JSON

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611532800000",
    "number": "1689695033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3421 CONCORD RD",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174029001",
            "telephone_number": "717-279-6700",
            "fax_number": "717-279-6759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "618 CORNWALL RD STE 2",
            "city": "LEBANON",
            "state": "PA",
            "postal_code": "170427089",
            "telephone_number": "717-279-6700",
            "fax_number": "717-279-6759"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HINKLE",
        "first_name": "MARY",
        "middle_name": "TIMM",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-21",
        "last_updated": "2021-01-25",
        "certification_date": "2021-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP000820B",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, PA

Sources for this page

Verify at the official NPI Registry.