Nicole Kathleen Govannicci, CRNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

SP026709 Issued in PA

Practice address

1244 Fort Washington Ave Ste E2
Fort Washington, PA 19034-1743

Phone

(215) 646-1686

NPI assigned

Dec 15, 2022

Sex

Female

Sole proprietor

Yes

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, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Family Practice Associates of Upper DublinGroup PAC ID 1850376211, 8 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/BEFDBD

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.

• Family Practice Associates of Upper Dublin

  • Family Medicine Physician
  • Fort Washington, PA
  • NPI 1811921166
  Medicare reassignment Care Compare group NPD
• Signify Health Medical Associates, PLLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1750845863

  PA

  Medicare reassignment NPD
• Abington Memorial Hospital

  • Sports Medicine (Family Medicine) Physician
  • Willow Grove, PA
  • NPI 1861742900
  NPD (past)

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

{
    "created_epoch": "1671062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740268800000",
    "number": "1891407409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2645 KIRK AVE",
            "city": "BROOMALL",
            "state": "PA",
            "postal_code": "190081915",
            "telephone_number": "610-787-2801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1244 FORT WASHINGTON AVE STE E2",
            "city": "FORT WASHINGTON",
            "state": "PA",
            "postal_code": "190341743",
            "telephone_number": "215-646-1686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOVANNICCI",
        "first_name": "NICOLE",
        "middle_name": "KATHLEEN",
        "credential": "CRNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-12-15",
        "last_updated": "2025-02-23",
        "certification_date": "2025-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP026709",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julie Gillen
• Cara Gillis
• Ashlie L Glasgow, PA-C
• Suzanne Grossman Goldstein, PHD
• Gordon Pediatric Speech Therapy LLC
• Donna Granick
• Jean E Gravil, LPN
• Great Spring Acupuncture, LLC
• Greater Life in Home Care Services
• Brooke Love Green, PT, DPT

• Family Nurse Practitioner in Fort Washington, PA
• Providers in Fort Washington, 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 Feb 23, 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.