Jerome C David, CRNP, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

SP015212 Issued in PA

Practice address

205 S Front St
5TH Floor, Bma
Harrisburg, PA 17104-1619

Phone

(717) 231-8360

Fax

(717) 231-8358

NPI assigned

Sep 3, 2015

Last updated

Mar 15, 2017By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1441238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489536000000",
    "number": "1881062131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 S 2ND ST",
            "address_2": "SUITE 2F",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171041612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 S FRONT ST",
            "address_2": "5TH FLOOR, BMA",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171041619",
            "telephone_number": "717-231-8360",
            "fax_number": "717-231-8358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVID",
        "first_name": "JEROME",
        "middle_name": "C",
        "credential": "CRNP, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-09-03",
        "last_updated": "2017-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "SP015212",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "PA",
            "license": "SP015212",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103050582",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Aratanxa Dave, MD
• Leonard Jason Davenport Jr.
• David Bronstein DO Richard H Jeffries DO Professional Assoc
• David M. Besselman, M.D. Pediatric Associates
• Michelle Dawn David-Hugues, M.D.
• Brian Martin Davidson, PA-C
• Noah Patrick Davidson, DO
• Jaclyn Davies, PA-C
• Mary C Davies, MD
• Amanda Davis-Buie

• Psychiatric/Mental Health Nurse Practitioner in Harrisburg, PA
• Providers in Harrisburg, PA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2017; 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.