Heather L Luckenbill, CRNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

SP012880 Issued in PA

Practice address

1701 Innovation Dr
York, PA 17408-8815

Phone

(717) 850-4040

Fax

(717) 850-4144

NPI assigned

Dec 14, 2011

Last updated

Jul 23, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NJ, PA2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Cooper Pediatric Specialists, PC

  • Pediatrics Physician
  • Camden, NJ
  • NPI 1306867585
  Medicare reassignment NPD
• Penn State Health Medical Group, LLC

  • Hematology & Oncology Physician
  • Harrisburg, PA
  • NPI 1861988644
  Medicare reassignment
• Penn State Health Medical Group, LLC

  • Diagnostic Radiology Physician
  • Harrisburg, PA
  • NPI 1457824013
  NPD
• Pinnacle Health Medical Services

  • Family Medicine Physician
  • Harrisburg, PA
  • NPI 1932143427
  NPD

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

{
    "created_epoch": "1323820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626998400000",
    "number": "1750650198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 INNOVATION DR",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174088815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 INNOVATION DR",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174088815",
            "telephone_number": "717-850-4040",
            "fax_number": "717-850-4144"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "111 S 11th St",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191074824",
            "country_code": "US",
            "telephone_number": "215-955-6000",
            "fax_number": "215-923-9519",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Cooper Plz",
            "address_purpose": "LOCATION",
            "city": "Camden",
            "state": "NJ",
            "postal_code": "081031461",
            "country_code": "US",
            "telephone_number": "856-342-2390",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LUCKENBILL",
        "first_name": "HEATHER",
        "middle_name": "L",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-12-14",
        "last_updated": "2021-07-23",
        "certification_date": "2021-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "SP012880",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "018033",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NJ",
            "license": "NJ00356100",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "PA",
            "license": "SP012880",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "PA",
            "license": "RN556384",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "NJ00356100",
            "state": "NJ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "hluckenbill198949@phsdirect.pinnaclehealth.org",
            "affiliation": "N",
            "address_1": "1701 Innovation Dr",
            "city": "York",
            "state": "PA",
            "country_code": "US",
            "postal_code": "174088815",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jessica Lowry, LCSW
• Tyler Loy, PSYD
• Allison Elizabeth Lozinak, OTR/L
• Quan Lu
• Melvin Elliott Lubart, OD
• Lulo Universitas Life Observatory, LLC
• Edward K Lulo, MD
• Kimberly R Lumsden, MD, PHD
• Chrysanthi Lundstedt, DO
• Lung Sleep and Critical Care Consultants, PC

• Pediatric Nurse Practitioner in York, PA
• Providers in York, PA by specialty
• Pediatric Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.