Individual provider Active NPI

Sara Carney, CRNP

  • Family Nurse Practitioner
  • Baltimore, MD
National Provider Identifier
1003489477
Registry record updated Jul 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R200801 Issued in MD
Practice address
250 W Pratt St
Baltimore, MD 21201-2423
Phone
(800) 492-5538
NPI assigned
Jul 22, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2021

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 R200801 MD Primary

Addresses

Primary practice location

250 W Pratt St
Baltimore, MD 21201-2423

Mailing address

4543 Necker Ave
Nottingham, MD 21236-2927

Other names 1

  • Sara Petersen Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20210811004427 MD Practitioner - Nurse Practitioner 4587068697 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Umms Ambulatory Care LLC Current Accepting new patients
Umms Ambulatory Care LLC CurrentSince Aug 16, 2021 Accepting new patients
Umms Ambulatory Care LLC CurrentSince Aug 16, 2021 Accepting new patients

Locations

711 W 40th St
Ste 173
Baltimore, MD 21211
Phone (443) 961-1221

8 Denton Plz
Denton, MD 21629
Phone (443) 606-2300

1730 Merritt Blvd
Dundalk, MD 21222
Phone (410) 282-2756

28522 Marlboro Ave
#C
Easton, MD 21601
Phone (443) 746-0086

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1626912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626912000000",
    "number": "1003489477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4543 NECKER AVE",
            "city": "NOTTINGHAM",
            "state": "MD",
            "postal_code": "212362927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 W PRATT ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212012423",
            "telephone_number": "800-492-5538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARNEY",
        "first_name": "SARA",
        "name_prefix": "Dr.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-22",
        "last_updated": "2021-07-22",
        "certification_date": "2021-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R200801",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SARA",
            "last_name": "PETERSEN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.