Khadeja Qubla Ibn Baidoo, CRNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R214238 Issued in MD

Practice address

4843 Marsden PL
Frederick, MD 21703-6822

Phone

(571) 275-6765

NPI assigned

Oct 8, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

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 1

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Meritus Medical Center IncGroup PAC ID 7113811795, shared by 8 NPIs, 730 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Khadeja Family Practice, LLC

  • Family Nurse Practitioner
  • Frederick, MD
  • NPI 1255942231
  Medicare reassignment Authorized official
• Opal Medical Group, P.a.

  • Internal Medicine Physician
  • Hagerstown, MD
  • NPI 1477639862
  Medicare reassignment NPD
• Frederick Health Hospital Inc

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)
• Phillip W. Stone, MD, LLC

  • Geriatric Medicine (Internal Medicine) Physician
  • Woodbine, MD
  • NPI 1912371832
  NPD (past)

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

{
    "created_epoch": "1570492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591920000000",
    "number": "1104467414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4843 MARSDEN PL",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217036822",
            "telephone_number": "571-275-6765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4843 MARSDEN PL",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217036822",
            "telephone_number": "571-275-6765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAIDOO",
        "first_name": "KHADEJA",
        "middle_name": "QUBLA IBN",
        "credential": "CRNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-10-08",
        "last_updated": "2020-06-12",
        "certification_date": "2020-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MD",
            "license": "R214238",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R214238",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ingrid Ida Backman, LCSW-C
• Courteney Bagley
• Josephine David Bagsic
• Jalika Jayda Bah
• Susan Bahl, MD
• Bernice Baier, LMFT
• Roomika Tanweer Baig, M.D.
• Amanda M Bailey, CRNP
• Felicia Dalphine Bailey, DNP, CRNP, FNP-C
• Jennifer Bailey

• Family Nurse Practitioner in Frederick, MD
• Providers in Frederick, MD by specialty
• Family Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.