Individual provider Active NPI

Timothy William Parker

  • Psychiatric/Mental Health Nurse Practitioner
  • Elkridge, MD
National Provider Identifier
1114761624
Registry record updated Jun 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
R247318 Issued in MD
Practice address
7220 Discovery Dr
Elkridge, MD 21075-7414
Phone
(240) 915-5500
NPI assigned
Jun 20, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X R247318 MD Primary

Addresses

Primary practice location

7220 Discovery Dr
Elkridge, MD 21075-7414

Mailing address

7220 Discovery Dr
Elkridge, MD 21075-7414
Phone (240) 915-5500

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
I20240813001301 MD Practitioner - Nurse Practitioner 5991243685 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Sheppard Pratt Physicians, P.a. CurrentSince Jul 31, 2024 Accepting new patients
Sheppard Pratt Health System, Inc Past Accepting new patients

Locations

100 Hospital Rd
Prnc Frederck, MD 20678
Phone (410) 414-4791

6501 N Charles St
Towson, MD 21204
Phone (410) 938-3000

Organizations & group practices 2

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": "1718841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718841600000",
    "number": "1114761624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7220 DISCOVERY DR",
            "city": "ELKRIDGE",
            "state": "MD",
            "postal_code": "210757414",
            "telephone_number": "240-915-5500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7220 DISCOVERY DR",
            "city": "ELKRIDGE",
            "state": "MD",
            "postal_code": "210757414",
            "telephone_number": "240-915-5500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARKER",
        "first_name": "TIMOTHY",
        "middle_name": "WILLIAM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-06-20",
        "last_updated": "2024-06-20",
        "certification_date": "2024-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R247318",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elkridge, MD

Sources for this page

Verify at the official NPI Registry.