Individual provider Active NPI

Priscilla Eyram Fosu

  • Nurse Practitioner
  • Baltimore, MD
National Provider Identifier
1154973154
Registry record updated Jun 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
R201675 Issued in MD
Practice address
22 S Greene St
Baltimore, MD 21201-1544
Phone
(410) 328-9595
NPI assigned
Jul 10, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 15, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X R201675 MD Primary

Addresses

Primary practice location

22 S Greene St
Baltimore, MD 21201-1544

Mailing address

22 S Greene St
Baltimore, MD 21201-1544
Phone (410) 328-9595

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
I20191217001007 MD Practitioner - Nurse Practitioner 5193159655 Reassigns benefits to 3 organizations
I20250815002052 DC Practitioner - Nurse Practitioner 5193159655 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MNR Industries, LLCGroup PAC ID 7416908843, 142 clinicians

Practice addresses (Care Compare)

1011 Baltimore Blvd
Westminster, MD 21157-7055
Phone (410) 848-3990

1311 Londontown Blvd
Suite 130
Eldersburg, MD 21784-6556
Phone (410) 549-7222

1505 E Churchville Rd
Bel Air, MD 21014-4742

17708 Garland Groh Blvd
Hagerstown, MD 21740-2016
Phone (301) 671-1772

504 E Ridgeville Blvd
A
Mount Airy, MD 21771-5942
Phone (301) 703-5452

9122 Hinks LN
Frederick, MD 21704-7005
Phone (240) 341-2654

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
MNR Industries LLC Current Accepting new patients
University of Maryland Emergency Medicine Associates, PA CurrentSince Oct 23, 2019 Accepting new patients
MNR Industries, LLC CurrentSince Aug 1, 2025 Accepting new patients
MNR Industries, LLC Current Accepting new patients
Hospitalist Medicine Physicians of Maryland-Frederick PC CurrentSince Jun 1, 2022 Accepting new patients
MNR Industries LLC CurrentSince Aug 1, 2025 Accepting new patients
MNR Industries, LLC CurrentSince Aug 1, 2025 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

821 N Eutaw St
Baltimore, MD 21201
Phone (410) 225-9185

22 S Greene St
Baltimore, MD 21201
Phone (410) 328-5793

1505 E Churchville Rd
#A
Bel Air, MD 21014
Phone (410) 420-6970

1505 E Churchville Rd
Bel Air, MD 21014
Phone (410) 420-6970

6000 Laurel Bowie Rd
Bowie, MD 20715
Phone (301) 383-0330

400 W 7th St
Frederick, MD 21701
Phone (240) 566-3300

504 E Ridgeville Blvd
#A
Mount Airy, MD 21771
Phone (301) 703-5452

Organizations & group practices 8

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": "1562716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686787200000",
    "number": "1154973154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 S GREENE ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212011544",
            "telephone_number": "410-328-9595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 S GREENE ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212011544",
            "telephone_number": "410-328-9595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOSU",
        "first_name": "PRISCILLA",
        "middle_name": "EYRAM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-07-10",
        "last_updated": "2023-06-15",
        "certification_date": "2023-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MD",
            "license": "R201675",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.