Individual provider Active NPI

Kari Ann Cheezum, CRNP

  • Family Nurse Practitioner
  • Salisbury, MD
National Provider Identifier
1003686601
Registry record updated Jan 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R134247 Issued in MD
Practice address
2425 N Salisbury Blvd
Salisbury, MD 21801-2138
Phone
(877) 222-4934
NPI assigned
Jan 4, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2024

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 R134247 MD Primary

Addresses

Primary practice location

2425 N Salisbury Blvd
Salisbury, MD 21801-2138

Mailing address

2425 N Salisbury Blvd
Salisbury, MD 21801-2138
Phone (877) 222-4934

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
I20240209000539 MD Practitioner - Nurse Practitioner 4789027434 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ydiprmc, LLCGroup PAC ID 3173897402, 29 clinicians

Practice addresses (Care Compare)

2425 N Salisbury Blvd
Salisbury, MD 21801-2138
Phone (443) 944-0196

Hospital & facility affiliations

  • Tidalhealth Peninsula Regional, Inc Hospital, Salisbury, MD, CCN 210019

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R134247MDMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ydiprmc LLC CurrentSince Feb 26, 2024 Accepting new patients

Locations

327 Tilghman Rd
Ste 200
Salisbury, MD 21804
Phone (410) 334-6351

2425 N Salisbury Blvd
Salisbury, MD 21801
Phone (410) 334-6351

Organizations & group practices 1

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1704326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704326400000",
    "number": "1003686601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2425 N SALISBURY BLVD",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218012138",
            "telephone_number": "877-222-4934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2425 N SALISBURY BLVD",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218012138",
            "telephone_number": "877-222-4934"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHEEZUM",
        "first_name": "KARI",
        "middle_name": "ANN",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-04",
        "last_updated": "2024-01-04",
        "certification_date": "2024-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R134247",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salisbury, MD

Sources for this page

Verify at the official NPI Registry.