Individual provider Active NPI

Kristin S. Dabbieri, AGNP-C

  • Adult Health Nurse Practitioner
  • Glen Burnie, MD
National Provider Identifier
1114652377
Registry record updated Nov 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
R192471 Issued in MD
Practice address
802 Landmark Dr Ste 120
Glen Burnie, MD 21061-9121
Phone
(410) 760-8840
NPI assigned
Jul 21, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X R192471 MD
Adult Health Nurse Practitioner 363LA2200X R192471 MD Primary

Addresses

Primary practice location

802 Landmark Dr Ste 120
Glen Burnie, MD 21061-9121

Mailing address

802 Landmark Dr Ste 119
Glen Burnie, MD 21061-9121
Phone (410) 760-8840

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20221129000756 MD Practitioner - Nurse Practitioner 5193193951 Reassigns benefits to 3 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Johns Hopkins Regional Physicians LLC Otolaryngology CurrentSince Nov 12, 2023 Accepting new patients
Privia Care Center LLC CurrentSince Nov 1, 2022 Accepting new patients
Privia Care Center LLC Current Accepting new patients
Johns Hopkins Regional Physicians LLC Current Accepting new patients
Menocal Medical Services PA Current Accepting new patients
Johns Hopkins Regional Physicians LLC CurrentSince Sep 1, 2023 Accepting new patients

Locations

133 Defense Hwy
Ste 109
Annapolis, MD 21401
Phone (410) 224-5558

10710 Charter Dr
Ste 400
Columbia, MD 21044
Phone (410) 997-7979

110 Baughmans Ln
Ste 140
Frederick, MD 21702
Phone (240) 215-1138

802 Landmark Dr
Ste 120
Glen Burnie, MD 21061

802 Landmark Dr
Ste 119
Glen Burnie, MD 21061
Phone 4107608840203

1300 York Rd
Ste 30D
Lutherville Timonium, MD 21093
Phone (443) 275-1337

950 N Glebe Rd
Ste 700
Arlington, VA 22203
Phone (484) 228-1065

Interoperability endpoints

  • Direct secure messaging: kdabbieri1115139@direct.hopkinsmedicine.org

Organizations & group practices 7

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": "1658361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701129600000",
    "number": "1114652377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "802 LANDMARK DR STE 119",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210619121",
            "telephone_number": "410-760-8840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "802 LANDMARK DR STE 120",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210619121",
            "telephone_number": "410-760-8840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DABBIERI",
        "first_name": "KRISTIN",
        "middle_name": "S.",
        "credential": "AGNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-21",
        "last_updated": "2023-11-28",
        "certification_date": "2023-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "MD",
            "license": "R192471",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MD",
            "license": "R192471",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Burnie, MD

Sources for this page

Verify at the official NPI Registry.