Individual provider Active NPI

Marla Brown

  • Primary Care Nurse Practitioner
  • Baltimore, MD
National Provider Identifier
1073050365
Registry record updated Jan 24, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
R165733 Issued in MD
Practice address
6821 Reisterstown Rd Ste 106
Baltimore, MD 21215-1434
Phone
(410) 358-6450
Fax
(410) 358-8511
NPI assigned
Jan 24, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 24, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X R165733 MD Primary

Addresses

Primary practice location

6821 Reisterstown Rd Ste 106
Baltimore, MD 21215-1434

Mailing address

6821 Reisterstown Rd Ste 106
Baltimore, MD 21215-1434
Phone (410) 358-6450

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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 1

Enrollment IDStateProvider typePAC IDDetails
I20180706001636 MD Practitioner - Nurse Practitioner 9133475007

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1485216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485216000000",
    "number": "1073050365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6821 REISTERSTOWN RD STE 106",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212151434",
            "telephone_number": "410-358-6450",
            "fax_number": "410-358-8511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6821 REISTERSTOWN RD STE 106",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212151434",
            "telephone_number": "410-358-6450",
            "fax_number": "410-358-8511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "MARLA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-01-24",
        "last_updated": "2017-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MD",
            "license": "R165733",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.