Individual provider Active NPI

Jessica C Halloran, CRNP

  • Nurse Practitioner
  • York, PA
National Provider Identifier
1851833263
Registry record updated Nov 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
SP016447 Issued in PA
Practice address
2350 Freedom Way
Suite 202
York, PA 17402-8200
Phone
(717) 851-2465
Fax
(717) 741-3043
NPI assigned
Nov 16, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X SP016447 PA Primary

Addresses

Primary practice location

2350 Freedom Way
Suite 202
York, PA 17402-8200

Mailing address

2350 Freedom Way
Suite 202
York, PA 17402-8200
Phone (717) 851-2465

Other names 1

  • Miss Jessica C Baltzell Former name

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
I20170112001718 PA Practitioner - Nurse Practitioner 3375825086 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellspan Medical GroupGroup PAC ID 1951213115, 2,438 clinicians

Practice addresses (Care Compare)

2350 Freedom Way
202 Wellspan Pulmonary and Sleep Medicine
York, PA 17402-8265
Phone (717) 851-2465

Hospital & facility affiliations

  • Wellspan York Hospital Hospital, York, PA, CCN 390046
  • Wellspan Chambersburg Hospital Hospital, Chambersburg, PA, CCN 390151

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
SP016447PAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wellspan Medical Group Nurse Practitioner CurrentSince Jan 9, 2017 Accepting new patients
Wellspan Medical Group Current Accepting new patients
Wellspan Medical Group CurrentSince Jan 9, 2017 Accepting new patients

Locations

2350 Freedom Way
Ste 202
York, PA 17402
Phone (717) 851-1543

25 Monument Rd
Ste 270
York, PA 17403
Phone (717) 741-8250

1600 S George St
York, PA 17403
Phone (717) 848-3615

Interoperability endpoints

  • Direct secure messaging: jhalloran107249@wellspan.direct-ci.com

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 and National Provider Directory roles.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1479254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479254400000",
    "number": "1851833263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2350 FREEDOM WAY",
            "address_2": "SUITE 202",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174028200",
            "telephone_number": "717-851-2465",
            "fax_number": "717-741-3043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2350 FREEDOM WAY",
            "address_2": "SUITE 202",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174028200",
            "telephone_number": "717-851-2465",
            "fax_number": "717-741-3043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALLORAN",
        "first_name": "JESSICA",
        "middle_name": "C",
        "name_prefix": "Mrs.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-16",
        "last_updated": "2016-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "SP016447",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "BALTZELL",
            "middle_name": "C",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in York, PA

Sources for this page

Verify at the official NPI Registry.