Individual provider Active NPI

Rose Obrien, AGNP

  • Gerontology Nurse Practitioner
  • Abbottstown, PA
National Provider Identifier
1710424817
Registry record updated Jan 26, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
SPO16952 Issued in PA
Practice address
127 Beaver Creek Rd
Abbottstown, PA 17301-8964
Phone
(717) 339-8229
NPI assigned
Jan 26, 2017
Last updated
Jan 26, 2017By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 26, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X SPO16952 PA Primary

Addresses

Primary practice location

127 Beaver Creek Rd
Abbottstown, PA 17301-8964

Mailing address

127 Beaver Creek Rd
Abbottstown, PA 17301-8964
Phone (717) 339-8229

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
I20170523000651 PA Practitioner - Nurse Practitioner 5092082081 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
SPO16952PAMDGerontology Nurse Practitioner

Organizations & group practices 1

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": "1485388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485388800000",
    "number": "1710424817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "127 BEAVER CREEK RD",
            "city": "ABBOTTSTOWN",
            "state": "PA",
            "postal_code": "173018964",
            "telephone_number": "717-339-8229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "127 BEAVER CREEK RD",
            "city": "ABBOTTSTOWN",
            "state": "PA",
            "postal_code": "173018964",
            "telephone_number": "717-339-8229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OBRIEN",
        "first_name": "ROSE",
        "credential": "AGNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-01-26",
        "last_updated": "2017-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "PA",
            "license": "SPO16952",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Abbottstown, PA

Sources for this page

Verify at the official NPI Registry.