Individual provider Active NPI

Jodylynn Mill, C.R.N.P.

  • Nurse Practitioner
  • West Reading, PA
National Provider Identifier
1699842807
Registry record updated Apr 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
SP008795 Issued in PA
Practice address
420 S 5TH Ave
West Reading, PA 19611-2143
Phone
(484) 328-3637
NPI assigned
Nov 30, 2006
Last updated
Apr 16, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2018

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 SP008795 PA Primary

Addresses

Primary practice location

420 S 5TH Ave
West Reading, PA 19611-2143

Mailing address

PO Box 13579
Reading, PA 19612-3579
Phone (484) 628-0799

Other practice location 1

6th Avenue & Spruce Street
West Reading, PA 19611
Phone (610) 988-8446

Other identifiers 1

IdentifierTypeStateIssuer
101515302MedicaidPA

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
I20060220000440 PA Practitioner - Nurse Practitioner 3971518515 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
SP008795PAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Tower Health Medical Group CurrentSince Jul 22, 2015 Accepting new patients
Reading Hospital CurrentSince Jun 17, 2009 Accepting new patients
Tower Health Medical Group Current Accepting new patients
Reading Hospital CurrentSince Jun 17, 2009 Accepting new patients
Tower Health Medical Group CurrentSince Jul 22, 2015 Accepting new patients
Reading Hospital Current Accepting new patients

Locations

206 S 6th Ave
West Reading, PA 19611
Phone (484) 628-5437

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

420 S 5th Ave
West Reading, PA 19611
Phone (484) 628-3637

6 Spruce St
West Reading, PA 19611
Phone (484) 628-8269

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

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523836800000",
    "number": "1699842807",
    "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": "484-628-0799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 S 5TH AVE",
            "city": "WEST READING",
            "state": "PA",
            "postal_code": "196112143",
            "telephone_number": "484-328-3637"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6th Avenue & Spruce Street",
            "address_purpose": "LOCATION",
            "city": "West Reading",
            "state": "PA",
            "postal_code": "19611",
            "country_code": "US",
            "telephone_number": "610-988-8446",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILL",
        "first_name": "JODYLYNN",
        "credential": "C.R.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-30",
        "last_updated": "2018-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "SP008795",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101515302",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Reading, PA

Sources for this page

Verify at the official NPI Registry.