Individual provider Active NPI

Clarissa McCudden Darr, RN

  • Psychiatric/Mental Health Nurse Practitioner
  • Frederick, MD
National Provider Identifier
1174653901
Registry record updated Jul 9, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
RN37188 Issued in DC
Practice address
1434 Porter St
Barquist Clinc, Ft Detrick
Frederick, MD 21702-9254
Phone
(301) 619-8096
Fax
(301) 619-2064
NPI assigned
Mar 7, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2013

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 RN37188 DC Primary

Addresses

Primary practice location

1434 Porter St
Barquist Clinc, Ft Detrick
Frederick, MD 21702-9254

Mailing address

15500 Villisca Ter
Derwood, MD 20855-2711
Phone (301) 762-3557

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN37188DCMDPsychiatric/Mental Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1373328000000",
    "number": "1174653901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15500 VILLISCA TER",
            "city": "DERWOOD",
            "state": "MD",
            "postal_code": "208552711",
            "telephone_number": "301-762-3557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1434 PORTER ST",
            "address_2": "BARQUIST CLINC, FT DETRICK",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217029254",
            "telephone_number": "301-619-8096",
            "fax_number": "301-619-2064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DARR",
        "first_name": "CLARISSA",
        "middle_name": "MCCUDDEN",
        "name_prefix": "Ms.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-07",
        "last_updated": "2013-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "DC",
            "license": "RN37188",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Frederick, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.