Individual provider Active NPI

Ann-Marie Codori, PH.D.

  • Clinical Psychologist
  • Baltimore, MD
National Provider Identifier
1073670733
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
02773 Issued in MD
Practice address
711 W 40TH St
Suite 316a
Baltimore, MD 21211-2120
Phone
(410) 235-6588
Fax
(410) 235-4350
NPI assigned
Jan 2, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 02773 MD Primary

Addresses

Primary practice location

711 W 40TH St
Suite 316a
Baltimore, MD 21211-2120

Mailing address

711 W 40TH St
Suite 316a
Baltimore, MD 21211-2120
Phone (410) 235-6588

Other identifiers 1

IdentifierTypeStateIssuer
GJ70OtherMDOLD PROVIDER NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Oct 1, 2021 through Oct 1, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

NPI Registry JSON

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

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1073670733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 W 40TH ST",
            "address_2": "SUITE 316A",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212112120",
            "telephone_number": "410-235-6588",
            "fax_number": "410-235-4350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 W 40TH ST",
            "address_2": "SUITE 316A",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212112120",
            "telephone_number": "410-235-6588",
            "fax_number": "410-235-4350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CODORI",
        "first_name": "ANN-MARIE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MD",
            "license": "02773",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OLD PROVIDER NUMBER",
            "identifier": "GJ70",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.