Individual provider Active NPI

Roshni Liz Chettiar, CRNP

  • Family Nurse Practitioner
  • Columbia, MD
National Provider Identifier
1124483029
Registry record updated Apr 4, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R187321 Issued in MD
Practice address
8850 Columbia 100 Pkwy
Suite 301
Columbia, MD 21045-2374
Phone
(301) 560-4747
Fax
(301) 776-1725
NPI assigned
Dec 18, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R187321 MD Primary

Addresses

Primary practice location

8850 Columbia 100 Pkwy
Suite 301
Columbia, MD 21045-2374

Mailing address

7350 Van Dusen Rd
Ste 130
Laurel, MD 20707-5267
Phone (301) 560-4747

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20161220001283 MD Practitioner - Nurse Practitioner 3971884545 Reassigns benefits to 1 organization
I20240708002516 DC Practitioner - Nurse Practitioner 3971884545 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R187321MDMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Padder Health Services, LLC CurrentSince Oct 2, 2016 Accepting new patients
Padder Health Services, LLC CurrentSince Oct 2, 2016 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

8860 Columbia 100 Pkwy
Ste 212
Columbia, MD 21045
Phone (301) 560-4747

9710 Patuxent Woods Dr
Ste 100
Columbia, MD 21046
Phone (301) 560-4747

9710 Patuxent Woods Dr
Columbia, MD 21046
Phone (443) 899-9525

8850 Columbia 100 Pkwy
Ste 308
Columbia, MD 21045
Phone (301) 560-4747

8850 Columbia 100 Pkwy
Ste 301
Columbia, MD 21045
Phone (240) 456-4772

7350 Van Dusen Rd
Ste 130
Laurel, MD 20707
Phone (301) 498-8880

7350 Van Dusen Rd
Ste B40
Laurel, MD 20707
Phone (240) 456-4772

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/AFEBAA
  • Direct secure messaging: roshni.chettiar@fphs.eclinicaldirectplus.com

Organizations & group practices 3

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": "1450396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491264000000",
    "number": "1124483029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7350 VAN DUSEN RD",
            "address_2": "STE 130",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207075267",
            "telephone_number": "301-560-4747",
            "fax_number": "301-776-1725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8850 COLUMBIA 100 PKWY",
            "address_2": "SUITE 301",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210452374",
            "telephone_number": "301-560-4747",
            "fax_number": "301-776-1725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHETTIAR",
        "first_name": "ROSHNI",
        "middle_name": "LIZ",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-18",
        "last_updated": "2017-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R187321",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MD

Sources for this page

Verify at the official NPI Registry.