Individual provider Active NPI

Erica Detweiler, FNP

  • Family Nurse Practitioner
  • Horsham, PA
National Provider Identifier
1922619378
Registry record updated Nov 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP022201 Issued in PA
Practice address
680 Blair Mill Rd
Horsham, PA 19044-2223
Phone
(215) 902-9014
NPI assigned
Aug 10, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X SP022201 PA Primary

Addresses

Primary practice location

680 Blair Mill Rd
Horsham, PA 19044-2223

Mailing address

186 Woodland Dr
White Haven, PA 18661-2439
Phone (570) 335-1961

Other practice location 1

186 Woodland Dr
White Haven, PA 18661-2439
Phone (570) 606-5615

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
I20240430001080 PA Order and Referring Only - Nurse Practitioner 9931511516

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
SP022201PAMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1597017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604620800000",
    "number": "1922619378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "186 WOODLAND DR",
            "city": "WHITE HAVEN",
            "state": "PA",
            "postal_code": "186612439",
            "telephone_number": "570-335-1961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "680 BLAIR MILL RD",
            "city": "HORSHAM",
            "state": "PA",
            "postal_code": "190442223",
            "telephone_number": "215-902-9014"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "186 Woodland Dr",
            "address_purpose": "LOCATION",
            "city": "White Haven",
            "state": "PA",
            "postal_code": "186612439",
            "country_code": "US",
            "telephone_number": "570-606-5615",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DETWEILER",
        "first_name": "ERICA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-10",
        "last_updated": "2020-11-06",
        "certification_date": "2020-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP022201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Horsham, PA

Sources for this page

Verify at the official NPI Registry.