Jessica Lake Buhr, CRNP
Individual provider Active NPI Gerontology Nurse Practitioner · Baltimore, MD
NPI 1013064799 · NPPES record last updated Jul 26, 2023
Key facts
- NPI
- 1013064799
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Gerontology Nurse Practitioner 363LG0600X
- License
- R089910 (MD)
- Practice address
- 1501 S Clinton St
Baltimore, MD 21224-5730 - Phone
- (866) 763-2211
- NPI assigned
- Jan 4, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (4 enrollments) in MD, DC, VA, TX
- 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 |
|---|---|---|---|---|
| I20140410001707 | MD | Practitioner - Nurse Practitioner | 0547492209 | Reassigns benefits to 1 organization |
| I20210129000130 | DC | Practitioner - Nurse Practitioner | 0547492209 | Reassigns benefits to 1 organization |
| I20210401002031 | VA | Practitioner - Nurse Practitioner | 0547492209 | Reassigns benefits to 1 organization |
| I20250514000759 | TX | Practitioner - Nurse Practitioner | 0547492209 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R089910 | MD | MD | Gerontology Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Center for Vascular Medicine LLC | Current |
Accepting new patients | |
| Center for Vascular Medicine NJ, LLC | Past | Accepting new patients | |
| Frederick Health Hospital Inc | Past | Accepting new patients |
Locations
108 Forbes St
Fl 2
Annapolis, MD 21401
Phone (301) 982-2000
7300 Hanover Dr
Ste 104
Greenbelt, MD 20770
Phone (301) 982-2000
7500 Greenway Center Dr
Ste 201
Greenbelt, MD 20770
8200 Greensboro Dr
Ste 210
McLean, VA 22102
Phone (703) 506-8346
Interoperability endpoints
- jessica.buhr@337577483108356.direct.elationemr.com
- jessica.buhr.1@28386.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gerontology Nurse Practitioner | 363LG0600X | R089910 | MD | Yes |
Addresses
Primary practice location
1501 S Clinton St
Baltimore, MD 21224-5730
Mailing address
1 Liberty PLZ Ste 301
New York, NY 10006-1404
Phone (917) 261-4414
Other providers in Baltimore, MD
- Stephanie Bugg
- Beth Ann Bughman
- Royce Buh Meh-Kah
- Desmond Camillo Buhagar
- Lynn Buhler
- Katherine Ma Bui
- Quang Ha Dang Bui
- Toan Song Bui
- Melissa K Buick
- Egypt Rejoni Buie
All providers in Baltimore, MD · Gerontology Nurse Practitioner in Maryland
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 26, 2023. 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.