Colleen Roach, CRNP-F

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R046352 Issued in MD

Practice address

6901 Security Blvd Ste 200
Windsor Mill, MD 21244-2412

Phone

(410) 837-2050

Fax

(410) 752-1374

NPI assigned

Jun 29, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Colleen Harrison Former name

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Chase Brexton Health Services, Inc.

  • Federally Qualified Health Center (FQHC)
  • Baltimore, MD
  • NPI 1588606305
  Medicare reassignment NPD
• Chase Brexton Health Services, Inc.

  • Federally Qualified Health Center (FQHC)
  • Columbia, MD
  • NPI 1376589309
  NPD

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

{
    "created_epoch": "1467158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704758400000",
    "number": "1154772200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6901 SECURITY BLVD STE 200",
            "city": "WINDSOR MILL",
            "state": "MD",
            "postal_code": "212442412",
            "telephone_number": "410-837-2050",
            "fax_number": "410-752-1374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6901 SECURITY BLVD STE 200",
            "city": "WINDSOR MILL",
            "state": "MD",
            "postal_code": "212442412",
            "telephone_number": "410-837-2050",
            "fax_number": "410-752-1374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROACH",
        "first_name": "COLLEEN",
        "credential": "CRNP-F",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-29",
        "last_updated": "2024-01-09",
        "certification_date": "2024-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R046352",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "COLLEEN",
            "last_name": "HARRISON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Realitycare Health Services
• Raymond R. Rembe, M.ED., CCC-A
• Michelle Reynolds
• Shaylon Taylor Rice
• Ride With Love, LLC
• Sonya Robb
• Gina M. Robinson, MA
• Aniya Dasean Rogers
• Mahdi Kawan Rover
• Laura A Rowlette

• Family Nurse Practitioner in Windsor Mill, MD
• Providers in Windsor Mill, MD by specialty
• Family Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.