Individual provider Active NPI

Jean E Gravil, LPN

  • Licensed Practical Nurse
  • Fort Washington, PA
National Provider Identifier
1982056958
Registry record updated Jul 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
296918 Issued in PA
Practice address
500 Office Center Dr
Suite 400
Fort Washington, PA 19034-3219
Phone
(267) 288-8950
NPI assigned
Jul 1, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 1, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 296918 PA Primary

Addresses

Primary practice location

500 Office Center Dr
Suite 400
Fort Washington, PA 19034-3219

Mailing address

500 Office Center Dr
Suite 400
Fort Washington, PA 19034-3219
Phone (267) 288-8950

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
296918PAMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1467331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467331200000",
    "number": "1982056958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 OFFICE CENTER DR",
            "address_2": "SUITE 400",
            "city": "FORT WASHINGTON",
            "state": "PA",
            "postal_code": "190343219",
            "telephone_number": "267-288-8950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 OFFICE CENTER DR",
            "address_2": "SUITE 400",
            "city": "FORT WASHINGTON",
            "state": "PA",
            "postal_code": "190343219",
            "telephone_number": "267-288-8950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAVIL",
        "first_name": "JEAN",
        "middle_name": "E",
        "name_prefix": "Mr.",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-07-01",
        "last_updated": "2016-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "PA",
            "license": "296918",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Washington, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.