Individual provider Active NPI

Kristy O'Dell Duffey, N.P.

  • Gerontology Nurse Practitioner
  • Elkridge, MD
National Provider Identifier
1104981224
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
R128753 Issued in MD
Practice address
6085 Marshalee Dr
Elkridge, MD 21075-6023
Phone
(410) 379-3528
Fax
(410) 379-3591
NPI assigned
Dec 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X R128753 MD Primary
Gerontology Nurse Practitioner 363LG0600X LD-0000115 DE
Gerontology Nurse Practitioner 363LG0600X RN1006277 DC

Addresses

Primary practice location

6085 Marshalee Dr
Elkridge, MD 21075-6023

Mailing address

8906 Winged Foot Dr
Pasadena, MD 21122-6670
Phone (410) 360-5140

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
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN1006277DCMDGerontology Nurse Practitioner
LD-0000115DEMDGerontology Nurse Practitioner
R128753MDMDGerontology Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1167177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104981224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8906 WINGED FOOT DR",
            "city": "PASADENA",
            "state": "MD",
            "postal_code": "211226670",
            "telephone_number": "410-360-5140",
            "fax_number": "410-379-3591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6085 MARSHALEE DR",
            "city": "ELKRIDGE",
            "state": "MD",
            "postal_code": "210756023",
            "telephone_number": "410-379-3528",
            "fax_number": "410-379-3591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUFFEY",
        "first_name": "KRISTY",
        "middle_name": "O'DELL",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MD",
            "license": "R128753",
            "primary": true
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "DE",
            "license": "LD-0000115",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "DC",
            "license": "RN1006277",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elkridge, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.