Individual provider Active NPI

Brittany Terese Cavanaugh, CPNP-PC

  • Pediatric Nurse Practitioner
  • Hazleton, PA
National Provider Identifier
1891423281
Registry record updated Sep 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
SP026032 Issued in PA
Practice address
564 W Broad St
Hazleton, PA 18201-6108
Phone
(484) 884-4500
NPI assigned
Aug 12, 2022
Last updated
Sep 5, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X SP026032 PA Primary
Neonatal Intensive Care Registered Nurse 163WN0002X RN707599 PA

Addresses

Primary practice location

564 W Broad St
Hazleton, PA 18201-6108

Mailing address

2100 Mack Blvd FL 4
Allentown, PA 18103-5622
Phone (484) 884-4500

Other names 1

  • Brittany Terese Cavanaugh 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
I20221130003534 PA Practitioner - Nurse Practitioner 2365810058 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN707599PAMDNeonatal Intensive Care Registered Nurse
SP026032PAMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lehigh Valley Physician Group CurrentSince Sep 13, 2024 Accepting new patients
Lehigh Valley Physician Group CurrentSince Sep 13, 2024 Accepting new patients
Geisinger Clinic Current Accepting new patients
Lehigh Valley Physician Group Current Accepting new patients
Geisinger Clinic CurrentSince Oct 24, 2022 Accepting new patients
Lehigh Valley Physician Group CurrentSince Sep 13, 2024 Accepting new patients
Hazleton Professional Services Current Accepting new patients
Geisinger Clinic CurrentSince Oct 24, 2022 Accepting new patients

Locations

1200 S Cedar Crest Blvd
Allentown, PA 18103
Phone (484) 862-3200

2100 Mack Blvd
Fl 4
Allentown, PA 18103

100 N Academy Ave
Danville, PA 17822

1000 Alliance Dr
#10
Hazleton, PA 18202
Phone (570) 501-6450

564 W Broad St
Hazleton, PA 18201
Phone (570) 501-6220

564 W Broad St
Ste 1
Hazleton, PA 18201
Phone (570) 501-2790

125 Scranton Pocono Hwy
Scranton, PA 18505
Phone (570) 342-8500

5 Morgan Hwy
Ste 8
Scranton, PA 18508
Phone (570) 207-4360

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1660262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725494400000",
    "number": "1891423281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 MACK BLVD FL 4",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181035622",
            "telephone_number": "484-884-4500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "564 W BROAD ST",
            "city": "HAZLETON",
            "state": "PA",
            "postal_code": "182016108",
            "telephone_number": "484-884-4500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAVANAUGH",
        "first_name": "BRITTANY",
        "middle_name": "TERESE",
        "name_prefix": "Mrs.",
        "credential": "CPNP-PC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-12",
        "last_updated": "2024-09-05",
        "certification_date": "2024-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "PA",
            "license": "SP026032",
            "primary": true
        },
        {
            "code": "163WN0002X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Neonatal Intensive Care",
            "state": "PA",
            "license": "RN707599",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRITTANY",
            "last_name": "CAVANAUGH",
            "middle_name": "TERESE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Hazleton, PA

Sources for this page

Verify at the official NPI Registry.