Shelley Deanna Martin, CRNP- FAMILY

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R139536 Issued in MD

Practice address

7450 Albert Rd
Brandywine, MD 20613-3035

Phone

(301) 599-0460

NPI assigned

Sep 19, 2022

Last updated

Sep 19, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MD, DC2 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

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Medstar Urgent Care LLCGroup PAC ID 9335303155, 300 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Medstar Urgent Care LLC

  dba MedStar PromptCare

  • Urgent Care Clinic/Center
  • Baltimore, MD
  • NPI 1902175870
  Medicare reassignment Care Compare group NPD
• Greater Baden Medical Service Incorporated

  • Federally Qualified Health Center (FQHC)
  • Brandywine, MD
  • NPI 1912927344

  DC, Family

  Medicare reassignment NPD
• Medstar Urgent Care, LLC

  dba MedStar PromptCare-Wheaton

  • Urgent Care Clinic/Center
  • Wheaton, MD
  • NPI 1871843409

  DC

  Medicare reassignment NPD
• Greater Baden Medical Service Incorporated

  • Federally Qualified Health Center (FQHC)
  • Lexington Park, MD
  • NPI 1487469243
  NPD
• Medstar Urgent Care LLC

  • General Practice Physician
  • Lexington Park, MD
  • NPI 1275410474
  NPD
• Medstar Urgent Care LLC

  dba MMG Urgent Care

  • Urgent Care Clinic/Center
  • Baltimore, MD
  • NPI 1942623319
  NPD

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

{
    "created_epoch": "1663545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663545600000",
    "number": "1073236774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11214 MATTAPONI RD",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "207728211",
            "telephone_number": "703-477-9031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7450 ALBERT RD",
            "city": "BRANDYWINE",
            "state": "MD",
            "postal_code": "206133035",
            "telephone_number": "301-599-0460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "SHELLEY",
        "middle_name": "DEANNA",
        "name_prefix": "Mrs.",
        "credential": "CRNP- FAMILY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-19",
        "last_updated": "2022-09-19",
        "certification_date": "2022-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R139536",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amina Maharjan
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• Claudine Asaah Mambo
• Vanessa Marcellus, DDS
• Maryland CVS Pharmacy LLC (CVS Pharmacy #17457)
• Maryland Oncology Hematology, P.a.
• Maryland Oncology Hematology, P.a.
• Aditya Mazmudar, MD, MBA
• Brittany McCollum, PHARMD

• Family Nurse Practitioner in Brandywine, MD
• Providers in Brandywine, MD by specialty
• Family Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.