Individual provider Active NPI

Jessica L Denigris, CRNP

  • Pediatric Nurse Practitioner
  • Bethlehem, PA
National Provider Identifier
1902550643
Registry record updated Feb 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
SP023054 Issued in PA
Practice address
325 W Broad St FL 2
Bethlehem, PA 18018-5526
Phone
(484) 626-9222
Fax
(484) 626-9220
NPI assigned
Feb 11, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X SP023054 PA Primary

Addresses

Primary practice location

325 W Broad St FL 2
Bethlehem, PA 18018-5526

Mailing address

2100 Mack Blvd FL 4
Allentown, PA 18103-5622
Phone (610) 390-8057

Other identifiers 1

IdentifierTypeStateIssuer
SP023054OtherPASTATE LICENSE

Other names 1

  • Jessica L Eberly 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
I20220218001355 PA Practitioner - Nurse Practitioner 0547654485 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lehigh Valley Physician Group CurrentSince Mar 21, 2022 Accepting new patients
Lehigh Valley Physician Group CurrentSince Mar 21, 2022 Accepting new patients
Lehigh Valley Physician Group Current Accepting new patients
Pulmonary Associates PC Past Accepting new patients

Locations

1611 Pond Rd
Ste 400
Allentown, PA 18104
Phone (610) 395-4300

2100 Mack Blvd
Fl 4
Allentown, PA 18103

325 W Broad St
Fl 2
Bethlehem, PA 18018
Phone (484) 626-9222

4807 Freemansburg Ave
Ste 100
Easton, PA 18045
Phone (484) 591-7620

2401 Northampton St
Ste 210
Easton, PA 18045
Phone (484) 591-7470

5649 Wynnewood Dr
Ste 104
Laurys Station, PA 18059
Phone (610) 262-6641

363 N 1st St
Lehighton, PA 18235
Phone (484) 464-9510

237 S Mountain Blvd
Ste 7
Mountain Top, PA 18707
Phone (570) 261-5000

3701 Corriere Rd
Ste 10
Palmer Township, PA 18045
Phone (484) 591-7060

320 W Pumping Station Rd
Ste 4
Quakertown, PA 18951
Phone (215) 529-4270

320 W Pumping Station Rd
Quakertown, PA 18951
Phone (215) 529-4240

3691 Crescent Ct E
Ste 100
Whitehall, PA 18052
Phone (610) 434-4294

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1644537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644537600000",
    "number": "1902550643",
    "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": "610-390-8057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 W BROAD ST FL 2",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180185526",
            "telephone_number": "484-626-9222",
            "fax_number": "484-626-9220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DENIGRIS",
        "first_name": "JESSICA",
        "middle_name": "L",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-11",
        "last_updated": "2022-02-11",
        "certification_date": "2022-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "PA",
            "license": "SP023054",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "SP023054",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "EBERLY",
            "middle_name": "L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bethlehem, PA

Sources for this page

Verify at the official NPI Registry.