Active NPI
Kristy O'Dell Duffey, N.P.
- Gerontology Nurse Practitioner
- Elkridge, MD
National Provider Identifier
1104981224
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gerontology Nurse Practitioner
- License
- R128753
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| RN1006277 | DC | MD | Gerontology Nurse Practitioner |
| LD-0000115 | DE | MD | Gerontology Nurse Practitioner |
| R128753 | MD | MD | Gerontology 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.