Individual provider Active NPI

Katherine Nugent, CRNA

  • Certified Registered Nurse Anesthetist
  • Baltimore, MD
National Provider Identifier
1053307595
Registry record updated Jan 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
R069863 Issued in MD
Practice address
3455 Wilkens Ave
Suite 100
Baltimore, MD 21229-5213
Phone
(410) 646-0331
Fax
(410) 644-6182
NPI assigned
Sep 20, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X R069863 MD Primary

Addresses

Primary practice location

3455 Wilkens Ave
Suite 100
Baltimore, MD 21229-5213

Mailing address

2515 Boston St
Unit P 1
Baltimore, MD 21224-4739
Phone (410) 967-7950

Other identifiers 1

IdentifierTypeStateIssuer
553121704MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
R069863MDMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Maryland Endoscopy Anesthesia LLC CurrentSince Apr 8, 2022 Accepting new patients
Woodholme Gastroenterology Assoc PA Past Accepting new patients
Endocentre at Quarterfield Station Past Accepting new patients

Locations

100 West Rd
Ste 115
Towson, MD 21204
Phone (410) 494-0144

Interoperability endpoints

  • Direct secure messaging: katherine.nugent.p1@direct.katzeneye.nextgenshare.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1127174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325721600000",
    "number": "1053307595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2515 BOSTON ST",
            "address_2": "UNIT P 1",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212244739",
            "telephone_number": "410-967-7950",
            "fax_number": "410-342-2655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3455 WILKENS AVE",
            "address_2": "SUITE 100",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212295213",
            "telephone_number": "410-646-0331",
            "fax_number": "410-644-6182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NUGENT",
        "first_name": "KATHERINE",
        "name_prefix": "Miss",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-20",
        "last_updated": "2012-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MD",
            "license": "R069863",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "553121704",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Jan 5, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.