Individual provider Active NPI

Brittany Raquel Johnson, NP

  • Psychiatry Physician
  • Baltimore, MD
National Provider Identifier
1134862709
Registry record updated Apr 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
R123456 Issued in MD
Practice address
2439 E Lafayette Ave
Baltimore, MD 21213-2562
Phone
(443) 797-2364
NPI assigned
Apr 20, 2022
Last updated
Apr 20, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X R123456 MD Primary

Addresses

Primary practice location

2439 E Lafayette Ave
Baltimore, MD 21213-2562

Mailing address

2439 E Lafayette Ave
Baltimore, MD 21213-2562
Phone (443) 797-2364

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
I20230616001617 MD Practitioner - Nurse Practitioner 4587022918 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2415 W Lafayette Ave
Suite D
Baltimore, MD 21216-4804

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R212734MDMDMental Health Counselor
R123456MDMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Spiritual Healing CurrentSince Jun 27, 2023 Accepting new patients
Toller Enterprises LLC CurrentSince Jul 4, 2023 Accepting new patients

Locations

2232 E Monument St
Baltimore, MD 21205
Phone (667) 207-3552

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1650412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650412800000",
    "number": "1134862709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2439 E LAFAYETTE AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212132562",
            "telephone_number": "443-797-2364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2439 E LAFAYETTE AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212132562",
            "telephone_number": "443-797-2364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "BRITTANY",
        "middle_name": "RAQUEL",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-20",
        "last_updated": "2022-04-20",
        "certification_date": "2022-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MD",
            "license": "R123456",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.