Individual provider Active NPI

Chinelo Asike, CRNP

  • Family Nurse Practitioner
  • Ellicott City, MD
National Provider Identifier
1073960852
Registry record updated Jun 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R200538 Issued in MD
Practice address
9055 Chevrolet Dr
#103
Ellicott City, MD 21042-4016
Phone
(410) 465-7850
NPI assigned
May 20, 2016
Last updated
Jun 5, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R200538 MD Primary

Addresses

Primary practice location

9055 Chevrolet Dr
#103
Ellicott City, MD 21042-4016

Mailing address

9055 Chevrolet Dr
#103
Ellicott City, MD 21042-4016
Phone (410) 465-7850

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20160824001226 MD Practitioner - Nurse Practitioner 4880989250 Reassigns benefits to 1 organization
I20210525002563 DC Practitioner - Nurse Practitioner 4880989250 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
24.81 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
82.71

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R200538MDMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Juniper Healthcare LLC CurrentSince Aug 1, 2016 Accepting new patients

Locations

6116 Belair Rd
Baltimore, MD 21206
Phone (410) 426-1424

9055 Chevrolet Dr
Ste 103
Ellicott City, MD 21042
Phone (443) 355-6290

12021 Livingston Rd
Ft Washington, MD 20744
Phone (301) 292-0300

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1463702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465084800000",
    "number": "1073960852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9055 CHEVROLET DR",
            "address_2": "#103",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210424016",
            "telephone_number": "410-465-7850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9055 CHEVROLET DR",
            "address_2": "#103",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210424016",
            "telephone_number": "410-465-7850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ASIKE",
        "first_name": "CHINELO",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-20",
        "last_updated": "2016-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R200538",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ellicott City, MD

Sources for this page

Verify at the official NPI Registry.