Mary Kathryn Waldrep, CRNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

SP033089 Issued in PA

Practice address

201 Park St
Honesdale, PA 18431-2051

Phone

(352) 299-3055

NPI assigned

Jul 24, 2025

Sex

Unspecified or another gender identity

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2025

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Hospital & facility affiliations

• Wayne Memorial Hospital Hospital, Honesdale, PA, CCN 390125

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.

• Wayne Memorial Community Health Centers

  • Federally Qualified Health Center (FQHC)
  • Honesdale, PA
  • NPI 1952395121
  Medicare reassignment NPD
• Wayne Memorial Community Health Centers

  • Federally Qualified Health Center (FQHC)
  • Honesdale, PA
  • NPI 1346000569
  NPD

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

• Wayne Memorial Hospital

  • General Acute Care Hospital
  • Honesdale, PA
  • NPI 1124026182
  Care Compare affiliation

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

{
    "created_epoch": "1753315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753315200000",
    "number": "1881576247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 PARK ST",
            "city": "HONESDALE",
            "state": "PA",
            "postal_code": "184312051",
            "telephone_number": "352-299-3055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 PARK ST",
            "city": "HONESDALE",
            "state": "PA",
            "postal_code": "184312051",
            "telephone_number": "352-299-3055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALDREP",
        "first_name": "MARY",
        "middle_name": "KATHRYN",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "X",
        "enumeration_date": "2025-07-24",
        "last_updated": "2025-07-24",
        "certification_date": "2025-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP033089",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Denise C Viola, D.O.
• Vision Innovation Centers of Pennsylvania LLC
• Amanda Leigh Vitali, LPC
• Wal-Mart Stores East LP (Wal-Mart Pharmacy 10-2480)
• Wal-Mart Stores East, LP (Vision Center 30-2480)
• Christina Lee Walker, RN
• Dorothy Walline, LCSW
• Walsh Counseling and Consultation Services
• Leonard T Walsh, MD
• Patricia A Walsh, LCSW

• Family Nurse Practitioner in Honesdale, PA
• Providers in Honesdale, PA by specialty
• Family Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.