Individual provider Active NPI

Shawna Marie Hutton, CRNP

  • Family Nurse Practitioner
  • Baltimore, MD
National Provider Identifier
1063012664
Registry record updated May 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R201776 Issued in MD
Practice address
22 S Greene St
Baltimore, MD 21201-1590
Phone
(410) 706-3100
NPI assigned
Nov 1, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R201776 MD Primary
Registered Nurse 163W00000X R201776 MD

Addresses

Primary practice location

22 S Greene St
Baltimore, MD 21201-1590

Mailing address

812 Oriole Ave
Glen Burnie, MD 21060-8428
Phone (443) 605-2263

Other practice location 1

12116 State Route 30
North Huntingdon, PA 15642-1843
Phone (724) 863-4362

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, PA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20210203000438 MD Practitioner - Nurse Practitioner 8921412909 Reassigns benefits to 2 organizations
I20220830002505 PA Practitioner - Nurse Practitioner 8921412909 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
92.3 of 100Reported as group
Quality
81.65
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R201776MDMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Urgent Care, PC - Pennsylvania Current Accepting new patients
Medexpress Urgent Care, PC - Pennsylvania CurrentSince Jan 1, 2024 Accepting new patients
Ahn Emergency Group of West Penn LTD. CurrentSince Jun 28, 2022 Accepting new patients
Medexpress Urgent Care, PC - Pennsylvania CurrentSince Jan 1, 2024 Accepting new patients
University of Maryland Midtown Health Inc CurrentSince Nov 17, 2020 Accepting new patients
University of Maryland Emergency Medicine Associates, PA CurrentSince Nov 16, 2020 Accepting new patients

Locations

105 Penn St
Baltimore, MD 21201
Phone (410) 328-2387

22 S Greene St
Baltimore, MD 21201
Phone (410) 328-5793

821 N Eutaw St
Baltimore, MD 21201
Phone (410) 225-9185

4808 Edgmont Ave
Brookhaven, PA 19015
Phone (610) 876-3072

12116 State Route 30
North Huntingdon, PA 15642
Phone (724) 382-5626

4800 Friendship Ave
Pittsburgh, PA 15224
Phone (412) 359-3030

7219 McKnight Rd
Ste F
Pittsburgh, PA 15237
Phone (412) 367-3278

Organizations & group practices 6

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": "1604188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716249600000",
    "number": "1063012664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "812 ORIOLE AVE",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210608428",
            "telephone_number": "443-605-2263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 S GREENE ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212011590",
            "telephone_number": "410-706-3100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12116 State Route 30",
            "address_purpose": "LOCATION",
            "city": "North Huntingdon",
            "state": "PA",
            "postal_code": "156421843",
            "country_code": "US",
            "telephone_number": "724-863-4362",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HUTTON",
        "first_name": "SHAWNA",
        "middle_name": "MARIE",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-01",
        "last_updated": "2024-05-21",
        "certification_date": "2024-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R201776",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MD",
            "license": "R201776",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.