Jill Van Earl, CRNP
Individual provider Active NPI Family Nurse Practitioner · Gordonville, PA
NPI 1982607818 · NPPES record last updated May 27, 2015
Key facts
- NPI
- 1982607818
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- SP010061 (PA)
- Practice address
- 3413 Harvest Dr
Gordonville, PA 17529-9586 - Phone
- (717) 768-7141
- Fax
- (717) 768-3528
- NPI assigned
- May 24, 2005
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20090311000245 | PA | Practitioner - Nurse Practitioner | 8022079656 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- No
- HHS exclusion list flag
- The National Provider Directory flags this NPI as appearing on an HHS exclusion list.
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wellspan Medical Group | Current |
Accepting new patients | |
| Wellspan Medical Group | Current |
Accepting new patients | |
| Wellspan Medical Group | Current | Accepting new patients | |
| Northern Lancaster County Medical Group | Past | Accepting new patients |
Locations
175 Martin Ave
Ste 125
Ephrata, PA 17522
Phone (717) 812-4602
4131 Oregon Pike
#C
Ephrata, PA 17522
25 Monument Rd
Ste 270
York, PA 17403
Phone (717) 741-8250
Interoperability endpoints
- jearl@direct-address.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | SP010061 | PA | Yes |
Addresses
Primary practice location
3413 Harvest Dr
Gordonville, PA 17529-9586
Mailing address
4131 Oregon Pike
Suite C
Ephrata, PA 17522-9550
Phone (717) 859-5161
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3647470 | Other | PA | AETNAHMO |
| 50038209 | Other | PA | GRP#/CAPBLUECROSS |
| EA1641588 | Other | PA | HIGHMARK BLUE SHEILD |
| 7233600 | Other | PA | AETNAPPO/PIN |
| 101205598 0001 | Medicaid | PA | |
| 50038208 | Other | PA | ID/CAPITOLBLUECROSS |
Other providers in Gordonville, PA
- Karlla Welch Brigatti
- Janice A Brightman
- Vincent Joseph Carson
- David A Fulginiti
- Gordonville Fire Company
- Gordonville Fire Company Ambulance
- Julia Goroff
- Ambur Rae Gregorio
All providers in Gordonville, PA · Family Nurse Practitioner in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 27, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.