Individual provider Active NPI

Craig Howard Fabian, RN

  • General Practice Registered Nurse
  • Baltimore, MD
National Provider Identifier
1104130616
Registry record updated Oct 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice Registered NurseTaxonomy code 163WG0000X
License
R203034 Issued in MD
Practice address
2711 Ailsa Ave
Baltimore, MD 21214-2520
Phone
(443) 900-2922
NPI assigned
Jul 27, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 16, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Registered Nurse 163WG0000X R203034 MD Primary

Addresses

Primary practice location

2711 Ailsa Ave
Baltimore, MD 21214-2520

Mailing address

2711 Ailsa Ave
Baltimore, MD 21214-2520
Phone (443) 900-2922

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
R203034MDMDGeneral Practice Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1280188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602806400000",
    "number": "1104130616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2711 AILSA AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212142520",
            "telephone_number": "443-900-2922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2711 AILSA AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212142520",
            "telephone_number": "443-900-2922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FABIAN",
        "first_name": "CRAIG",
        "middle_name": "HOWARD",
        "name_prefix": "Mr.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-07-27",
        "last_updated": "2020-10-16",
        "certification_date": "2020-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "MD",
            "license": "R203034",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.