Individual provider Active NPI

Jeffrey T Nold, DO

  • Pediatric Adolescent Medicine Physician
  • Annapolis, MD
National Provider Identifier
1053488841
Registry record updated Feb 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X
License
H0044538 Issued in MD
Practice address
2024 West St Ste 400
Annapolis, MD 21401-3552
Phone
(410) 224-7667
Fax
(410) 573-4926
NPI assigned
Nov 29, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 28, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Adolescent Medicine Physician 2080A0000X H0044538 MD Primary

Addresses

Primary practice location

2024 West St Ste 400
Annapolis, MD 21401-3552

Mailing address

2568A Riva Rd
Suite 103
Annapolis, MD 21401-7445
Phone (410) 224-7667

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, MD2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20150710001167 DC Practitioner - Pediatric Medicine 3072825678 Reassigns benefits to 1 organization
I20150710001513 MD Practitioner - Pediatric Medicine 3072825678 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Philadelphia College of Osteopathic Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Privia Medical Group, LLCGroup PAC ID 4385682061, 1,522 clinicians

Practice addresses (Care Compare)

133 Defense Hwy
Annapolis, MD 21401-7015

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
H0044538MDMDPediatric Adolescent Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group, LLC CurrentSince Jun 28, 2015 Accepting new patients
Privia Medical Group, LLC Adolescent Medicine CurrentSince Jun 28, 2015 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Nova Physician Wellness Center PLLC Past Accepting new patients

Locations

133 Defense Hwy
Ste 112
Annapolis, MD 21401
Phone (410) 573-0140

2024 West St
Ste 400
Annapolis, MD 21401
Phone (410) 224-7667

2568A Riva Rd
Ste 103
Annapolis, MD 21401
Phone (410) 224-7667

9470 Annapolis Rd
Ste 309
Lanham, MD 20706
Phone (202) 832-1800

11350 Pembrooke Sq
Ste 304
Waldorf, MD 20603
Phone (301) 856-2810

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/8042/brand/1/csg/1/fhir/r4
  • Direct secure messaging: jeffrey.nold.1@8042.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/1993/brand/1/csg/1/fhir/r4

Organizations & group practices 4

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": "1164758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677542400000",
    "number": "1053488841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2568A RIVA RD",
            "address_2": "SUITE 103",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214017445",
            "telephone_number": "410-224-7667",
            "fax_number": "410-573-4926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2024 WEST ST STE 400",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214013552",
            "telephone_number": "410-224-7667",
            "fax_number": "410-573-4926"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOLD",
        "first_name": "JEFFREY",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-29",
        "last_updated": "2023-02-28",
        "certification_date": "2023-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "MD",
            "license": "H0044538",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Annapolis, MD

Sources for this page

Verify at the official NPI Registry.