Organization Active NPI

Johns Hopkins University

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Baltimore, MD
National Provider Identifier
1023665262
Registry record updated Mar 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X
Legal business name
JOHNS HOPKINS UNIVERSITY
Practice address
600 N Wolfe St
Baltimore, MD 21287-0005
Phone
(410) 955-5000
NPI assigned
Aug 22, 2019
Organization subpart
Yes
Parent organization
JOHNS HOPKINS UNIVERSITYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 7, 2021

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

Authorized official

Name
Shavonda L Keating
Title
Sr Production Unit MGR
Phone
(410) 933-6430

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Orthopaedic Surgery) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207XX0005X Primary

Addresses

Primary practice location

600 N Wolfe St
Baltimore, MD 21287-0005

Mailing address

PO Box 64664
Baltimore, MD 21264-4664
Phone (410) 933-6423

Other identifiers 1

IdentifierTypeStateIssuer
131688501MedicaidMD

Other names 2

  • JHU - ORTHOPEADIC SURGERY/SPORTS MEDICINE Doing business as
  • JHU - ORTHOPEDIC SURGERY Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20191008000962 MD Part B Supplier - Hospital Department(S) 4981745098 Receives reassigned benefits from 5 practitioners
Practice locations: Columbia, MD; Nottingham, MD; Lutherville, MD; Baltimore, MD
O20191010000854 DC Part B Supplier - Hospital Department(S) 4981745098 Receives reassigned benefits from 2 practitioners
Practice locations: Bethesda, MD; Washington, DC

National Provider Directory

National Provider Directory
Part of
Johns Hopkins Univ Emer

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1566432000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1615075200000",
    "number": "1023665262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 64664",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212644664",
            "telephone_number": "410-933-6423",
            "fax_number": "410-933-1390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 N WOLFE ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212870005",
            "telephone_number": "410-955-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHNS HOPKINS UNIVERSITY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "JOHNS HOPKINS UNIVERSITY",
        "enumeration_date": "2019-08-22",
        "last_updated": "2021-03-07",
        "certification_date": "2021-03-07",
        "status": "A",
        "authorized_official_last_name": "KEATING",
        "authorized_official_first_name": "SHAVONDA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "SR PRODUCTION UNIT MGR",
        "authorized_official_telephone_number": "410-933-6430"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "131688501",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "JHU - ORTHOPEADIC SURGERY/SPORTS MEDICINE",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "JHU - ORTHOPEDIC SURGERY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.