Individual provider Active NPI

Anju Liz Johnson, CRNP

  • Nurse Practitioner
  • Bethesda, MD
National Provider Identifier
1104392513
Registry record updated Nov 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
R202794 Issued in MD
Practice address
6410 Rockledge Dr Ste 503
Bethesda, MD 20817-7822
Phone
(301) 530-1700
NPI assigned
Oct 23, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X R202794 MD Primary

Addresses

Primary practice location

6410 Rockledge Dr Ste 503
Bethesda, MD 20817-7822

Mailing address

25 Crossroads Dr Ste 306
Owings Mills, MD 21117-5437
Phone (410) 581-1600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, MD2 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
I20181231000611 DC Practitioner - Nurse Practitioner 9032454681 Reassigns benefits to 2 organizations
I20210219000760 MD Practitioner - Nurse Practitioner 9032454681 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Chesapeake Urology Associates, LLC CurrentSince Sep 1, 2020 Accepting new patients
Chesapeake Urology Associates, LLC Current Accepting new patients
Chesapeake Urology Associates LLC CurrentSince Sep 1, 2020 Accepting new patients
Medical Faculty Associates, Inc CurrentSince Nov 26, 2018 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Chesapeake Urology Associates, LLC Past Accepting new patients

Locations

900 23rd St NW
Washington, DC 20037
Phone (202) 715-4750

6410 Rockledge Dr
Ste 503
Bethesda, MD 20817
Phone (301) 530-1700

7321 Hanover Pkwy
Greenbelt, MD 20770
Phone (240) 463-3788

7580 Buckingham Blvd
Ste 100
Hanover, MD 21076

25 Crossroads Dr
Ste 306
Owings Mills, MD 21117
Phone (443) 231-1681

10200 Grand Central Ave
Ste 220
Owings Mills, MD 21117

1838 Greene Tree Rd
Ste 460
Pikesville, MD 21208
Phone (410) 581-8140

3801 International Dr
Ste 310
Silver Spring, MD 20906
Phone (301) 598-9171

Interoperability endpoints

  • Direct secure messaging: ajohnson780192@direct.hopkinsmedicine.org

Organizations & group practices 6

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": "1540252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604534400000",
    "number": "1104392513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 CROSSROADS DR STE 306",
            "city": "OWINGS MILLS",
            "state": "MD",
            "postal_code": "211175437",
            "telephone_number": "410-581-1600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6410 ROCKLEDGE DR STE 503",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208177822",
            "telephone_number": "301-530-1700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "ANJU",
        "middle_name": "LIZ",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-23",
        "last_updated": "2020-11-05",
        "certification_date": "2020-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MD",
            "license": "R202794",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethesda, MD

Sources for this page

Verify at the official NPI Registry.