Individual provider Active NPI

Karen A Lodge, CRNP

  • Acute Care Nurse Practitioner
  • Wyndmoor, PA
National Provider Identifier
1699923219
Registry record updated Sep 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
SP005181C Issued in PA
Practice address
8200 Flourtown Ave
Suite 2
Wyndmoor, PA 19038-7976
Phone
(215) 341-1777
NPI assigned
Sep 8, 2008
Last updated
Sep 19, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X SP005181C PA Primary

Addresses

Primary practice location

8200 Flourtown Ave
Suite 2
Wyndmoor, PA 19038-7976

Mailing address

1 Bartol Ave
Ste 14
Ridley Park, PA 19078-2214
Phone (215) 341-1777

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
I20160527001233 PA Practitioner - Nurse Practitioner 7517257843 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of Penn-Medical Group CurrentSince Jun 17, 2019 Accepting new patients
University of Penn-Medical Group Current Accepting new patients
University of Penn-Medical Group CurrentSince Jun 17, 2019 Accepting new patients

Locations

230 W Washington Sq
Ste 101
Philadelphia, PA 19106
Phone (215) 829-6320

700 Spruce St
Ste 305
Philadelphia, PA 19106
Phone (215) 829-2092

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, 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": "1220832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474243200000",
    "number": "1699923219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 BARTOL AVE",
            "address_2": "STE 14",
            "city": "RIDLEY PARK",
            "state": "PA",
            "postal_code": "190782214",
            "telephone_number": "215-341-1777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8200 FLOURTOWN AVE",
            "address_2": "SUITE 2",
            "city": "WYNDMOOR",
            "state": "PA",
            "postal_code": "190387976",
            "telephone_number": "215-341-1777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LODGE",
        "first_name": "KAREN",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-08",
        "last_updated": "2016-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "PA",
            "license": "SP005181C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyndmoor, PA

Sources for this page

Verify at the official NPI Registry.