Individual provider Active NPI

Michele Anne McComas, RN

  • Ambulatory Care Registered Nurse
  • Baltimore, MD
National Provider Identifier
1104468081
Registry record updated Oct 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Care Registered NurseTaxonomy code 163WP2201X
License
R069199 Issued in MD
Practice address
2800 Kirk Ave
Baltimore, MD 21218-3647
Phone
(410) 467-7140
Fax
(410) 467-7141
NPI assigned
Oct 12, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Care Registered Nurse 163WP2201X R069199 MD Primary

Addresses

Primary practice location

2800 Kirk Ave
Baltimore, MD 21218-3647

Mailing address

2800 Kirk Ave
Baltimore, MD 21218-3647
Phone (410) 467-7140

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address michele.mccomas@shepherdsclinic.org Direct

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
R069199MDMDAmbulatory Care Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1570838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570838400000",
    "number": "1104468081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 KIRK AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212183647",
            "telephone_number": "410-467-7140",
            "fax_number": "410-467-7141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 KIRK AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212183647",
            "telephone_number": "410-467-7140",
            "fax_number": "410-467-7141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCOMAS",
        "first_name": "MICHELE",
        "middle_name": "ANNE",
        "name_prefix": "Ms.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-12",
        "last_updated": "2019-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP2201X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Ambulatory Care",
            "state": "MD",
            "license": "R069199",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "michele.mccomas@shepherdsclinic.org",
            "affiliation": "N",
            "endpointDescription": "business email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "email",
            "address_1": "2800 Kirk Ave",
            "city": "Baltimore",
            "state": "MD",
            "country_code": "US",
            "postal_code": "212183647",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "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 12, 2019; 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.