Individual provider Active NPI

Deborah M. Reid, FNP-BC

  • Family Nurse Practitioner
  • Chestertown, MD
National Provider Identifier
1093901274
Registry record updated May 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R213017 Issued in MD
Practice address
312 Park Row
Chestertown, MD 21620-1550
Phone
(410) 990-1202
Fax
(410) 990-1203
NPI assigned
Sep 20, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 31, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN280341 MA
Family Nurse Practitioner 363LF0000X 79411 WV
Family Nurse Practitioner 363LF0000X 0024169074 VA
Family Nurse Practitioner 363LF0000X R213017 MD Primary

Addresses

Primary practice location

312 Park Row
Chestertown, MD 21620-1550

Mailing address

312 Park Row
Chestertown, MD 21620-1550
Phone (410) 990-1202

Other identifiers 4

IdentifierTypeStateIssuer
970500MedicaidAZ
8HE544OtherAZMEDICARE PART B - CHINLE
8HE545OtherAZMEDICARE PART B - PINON
8HE546OtherAZMEDICARE PART B - TSAILE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Apr 1, 2022 through Apr 1, 2028

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
002518CTMDClinical Psychologist
RN280341MAMDFamily Nurse Practitioner
R213017MDMDFamily Nurse Practitioner
0024169074VAMDFamily Nurse Practitioner
79411WVMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sanford Clinic Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: deborah.reid.1@19185.direct.athenahealth.com

Organizations & group practices 2

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": "1190246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685491200000",
    "number": "1093901274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "312 PARK ROW",
            "city": "CHESTERTOWN",
            "state": "MD",
            "postal_code": "216201550",
            "telephone_number": "410-990-1202",
            "fax_number": "410-990-1203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "312 PARK ROW",
            "city": "CHESTERTOWN",
            "state": "MD",
            "postal_code": "216201550",
            "telephone_number": "410-990-1202",
            "fax_number": "410-990-1203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REID",
        "first_name": "DEBORAH",
        "middle_name": "M.",
        "name_prefix": "Ms.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-20",
        "last_updated": "2023-05-31",
        "certification_date": "2023-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "RN280341",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WV",
            "license": "79411",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024169074",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R213017",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "970500",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PART B - CHINLE",
            "identifier": "8HE544",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PART B - PINON",
            "identifier": "8HE545",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PART B - TSAILE",
            "identifier": "8HE546",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chestertown, MD

Sources for this page

Verify at the official NPI Registry.