Active NPI
Johns Hopkins University
- Sports Medicine (Orthopaedic Surgery) Physician
- Baltimore, MD
National Provider Identifier
1023665262
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Sports Medicine (Orthopaedic Surgery) Physician
- 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 UNIVERSITY
NPPES NPI Registry
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Sports Medicine (Orthopaedic Surgery) Physician | 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 131688501 | Medicaid | MD |
Other names 2
- JHU - ORTHOPEADIC SURGERY/SPORTS MEDICINE
- JHU - ORTHOPEDIC SURGERY
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MD, DC
Enrollment records 2
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.
-
- Orthopaedic Surgery Physician
- Columbia, MD
- NPI 1972649531
-
- Orthopaedic Surgery Physician
- Lutherville, MD
- NPI 1780631861
-
- Orthopaedic Surgery Physician
- Lutherville, MD
- NPI 1467401018
-
- Orthopaedic Surgery Physician
- Baltimore, MD
- NPI 1093746422
-
- Sports Medicine (Orthopaedic Surgery) Physician
- Lutherville, MD
- NPI 1699741736
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.