Individual provider Active NPI

Ashley Elizabeth Needham, FNP-BC

  • Nurse Practitioner
  • Charlotte Hall, MD
National Provider Identifier
1013587724
Registry record updated Feb 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
R199683 Issued in MD
Practice address
37767 Market Dr Unit 200
Charlotte Hall, MD 20622-3199
Phone
(301) 884-2062
NPI assigned
Jun 26, 2021
Last updated
Feb 5, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X R199683 MD Primary

Addresses

Primary practice location

37767 Market Dr Unit 200
Charlotte Hall, MD 20622-3199

Mailing address

29161 Hearts Desire Dr
Mechanicsville, MD 20659-4749
Phone (240) 434-1158

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
I20210712002789 MD Practitioner - Nurse Practitioner 5991107054 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Shah Dermatology LLCGroup PAC ID 4587981550, 6 clinicians

Practice addresses (Care Compare)

37767 Market Dr
Unit 2
Charlotte Hall, MD 20622-3198
Phone (301) 884-0278

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Shah Dermatology LLC Dermatology CurrentSince Jul 6, 2021 Accepting new patients
Center for Vein Restoration MD LLC PastSince Jul 4, 2021 Accepting new patients

Locations

37767 Market Dr
Unit 2
Charlotte Hall, MD 20622
Phone (301) 884-0278

37767 Market Dr
Unit 200
Charlotte Hall, MD 20622
Phone (301) 884-0278

10 Saint Patricks Dr
Fl 3
Waldorf, MD 20603
Phone (240) 448-2970

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1624665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644019200000",
    "number": "1013587724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29161 HEARTS DESIRE DR",
            "city": "MECHANICSVILLE",
            "state": "MD",
            "postal_code": "206594749",
            "telephone_number": "240-434-1158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37767 MARKET DR UNIT 200",
            "city": "CHARLOTTE HALL",
            "state": "MD",
            "postal_code": "206223199",
            "telephone_number": "301-884-2062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEEDHAM",
        "first_name": "ASHLEY",
        "middle_name": "ELIZABETH",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-26",
        "last_updated": "2022-02-05",
        "certification_date": "2022-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MD",
            "license": "R199683",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte Hall, MD

Sources for this page

Verify at the official NPI Registry.