Individual provider Active NPI

Kenneth Reichenbach Jr., CRNP

  • Family Nurse Practitioner
  • Allentown, PA
National Provider Identifier
1700021730
Registry record updated Feb 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP009995 Issued in PA
Practice address
1210 S Cedar Crest Blvd
Suite 2800
Allentown, PA 18103-6229
Phone
(610) 402-9008
Fax
(610) 402-9006
NPI assigned
Dec 4, 2008
Last updated
Feb 17, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X SP009995 PA Primary
Gerontology Nurse Practitioner 363LG0600X SP009995 PA
Registered Nurse 163W00000X RN530752L PA

Addresses

Primary practice location

1210 S Cedar Crest Blvd
Suite 2800
Allentown, PA 18103-6229

Mailing address

PO Box 783311
Philadelphia, PA 19178-3311

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
I20090121000430 PA Practitioner - Nurse Practitioner 0941364855 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN530752LPAMDRegistered Nurse
SP009995PAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Imaging of Lehigh Valley PC CurrentSince Oct 24, 2009 Accepting new patients
Lehigh Valley Physician Group CurrentSince Dec 12, 2008 Accepting new patients
Lehigh Valley Physician Group CurrentSince Dec 12, 2008 Accepting new patients
Lehigh Valley Physician Group Nurse Practitioner Current Accepting new patients
Pulmonary Associates PC Past Accepting new patients

Locations

1200 S Cedar Crest Blvd
Allentown, PA 18103
Phone (484) 862-3200

1210 S Cedar Crest Blvd
Ste 2800
Allentown, PA 18103
Phone (610) 402-9008

2100 Mack Blvd
Fl 4
Allentown, PA 18103

700 Hawk Ridge Dr
Hamburg, PA 19526
Phone (610) 562-0170

281 N 12th St
Ste B
Lehighton, PA 18235
Phone (610) 377-7793

Interoperability endpoints

  • Direct secure messaging: kreichenbach11896@direct2.lvhn.org

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": "1228348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739750400000",
    "number": "1700021730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 783311",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191783311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1210 S CEDAR CREST BLVD",
            "address_2": "SUITE 2800",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181036229",
            "telephone_number": "610-402-9008",
            "fax_number": "610-402-9006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REICHENBACH",
        "first_name": "KENNETH",
        "name_suffix": "Jr.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-12-04",
        "last_updated": "2025-02-17",
        "certification_date": "2025-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP009995",
            "primary": true
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "PA",
            "license": "SP009995",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "PA",
            "license": "RN530752L",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Allentown, PA

Sources for this page

Verify at the official NPI Registry.