Individual provider Active NPI

Anita Gill

  • Family Nurse Practitioner
  • Philadelphia, PA
National Provider Identifier
1932653037
Registry record updated May 4, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP016353 Issued in PA
Practice address
7131-39 Frankford Avenue
Philadelphia, PA 19135-1008
Phone
(215) 332-4164
Fax
(215) 332-9638
NPI assigned
Aug 8, 2016
Last updated
May 4, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 4, 2017

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 SP016353 PA Primary

Addresses

Primary practice location

7131-39 Frankford Avenue
Philadelphia, PA 19135-1008

Mailing address

5501 Old York Rd
Korman-Suite 202
Philadelphia, PA 19141-3018
Phone (215) 254-2612

Other identifiers 1

IdentifierTypeStateIssuer
RN582361OtherPARN LICENSE

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
I20170623000094 PA Practitioner - Nurse Practitioner 9830467414 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Spectrum Health Services IncGroup PAC ID 0840242467, 21 clinicians

Practice addresses (Care Compare)

1415 N Broad St
Suite 224
Philadelphia, PA 19122-3325
Phone (267) 275-4095

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Spectrum Health Services, Inc. CurrentSince May 16, 2018 Accepting new patients
Spectrum Health Services, Inc. CurrentSince May 16, 2018 Accepting new patients
Spectrum Health Services Inc PastSince May 16, 2018 Accepting new patients

Locations

1415 N Broad St
Ste 224
Philadelphia, PA 19122
Phone (267) 275-4095

3525 Cottman Ave
Philadelphia, PA 19149
Phone (267) 536-5085

5201 Haverford Ave
Philadelphia, PA 19139
Phone (215) 472-6097

Interoperability endpoints

  • Direct secure messaging: anita.gill.1@20090.direct.athenahealth.com
  • Direct secure messaging: anita.gill@direct.einstein.edu

Organizations & group practices 3

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": "1470614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493856000000",
    "number": "1932653037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5501 OLD YORK RD",
            "address_2": "KORMAN-SUITE 202",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191413018",
            "telephone_number": "215-254-2612",
            "fax_number": "215-456-5926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7131-39 FRANKFORD AVENUE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191351008",
            "telephone_number": "215-332-4164",
            "fax_number": "215-332-9638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILL",
        "first_name": "ANITA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-08",
        "last_updated": "2017-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP016353",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN LICENSE",
            "identifier": "RN582361",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.