Individual provider Active NPI

Bernadette Musgrove, LPN

  • Licensed Practical Nurse
  • Forest City, PA
National Provider Identifier
1720414261
Registry record updated Sep 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
291391 Issued in PA
Practice address
238 Delaware Street
Forest City, PA 18421
Phone
(570) 785-2624
NPI assigned
Sep 16, 2013
Last updated
Sep 16, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 291391 PA Primary

Addresses

Primary practice location

238 Delaware Street
Forest City, PA 18421

Mailing address

181 Freethy Pond Road
Honesdale, PA 18431
Phone (570) 647-6807

Other identifiers 1

IdentifierTypeStateIssuer
291391OtherPALPN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
291391PAMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1379289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379289600000",
    "number": "1720414261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "181 FREETHY POND ROAD",
            "city": "HONESDALE",
            "state": "PA",
            "postal_code": "18431",
            "telephone_number": "570-647-6807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "238 DELAWARE STREET",
            "city": "FOREST CITY",
            "state": "PA",
            "postal_code": "18421",
            "telephone_number": "570-785-2624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUSGROVE",
        "first_name": "BERNADETTE",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-16",
        "last_updated": "2013-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "PA",
            "license": "291391",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LPN",
            "identifier": "291391",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest City, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.