Individual provider Active NPI

Christi Ann Dieterich, NP

  • Gerontology Nurse Practitioner
  • Elkridge, MD
National Provider Identifier
1184873895
Registry record updated Oct 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
R146251 Issued in MD
Practice address
6095 Marshalee Dr
Elkridge, MD 21075-6053
Phone
(410) 279-3284
NPI assigned
Sep 17, 2008
Last updated
Oct 5, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X R146251 MD Primary

Addresses

Primary practice location

6095 Marshalee Dr
Elkridge, MD 21075-6053

Mailing address

2783 Autumn Chase Run
Annapolis, MD 21401-7259
Phone (443) 414-6411

Other names 1

  • Christi Ann Mowery Former name

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
I20110525000649 MD Practitioner - Nurse Practitioner 0648456707 Reassigns benefits to 1 organization
I20210806000010 DC Practitioner - Nurse Practitioner 0648456707 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Aditya Chopra, MD, PCGroup PAC ID 5395723399, 3 clinicians

Practice addresses (Care Compare)

600 Ridgely Ave
Suite 231
Annapolis, MD 21401-1092
Phone (410) 266-8116

7600 Laurel Bowie Rd
Bowie, MD 20715-1075
Phone (410) 266-8116

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
17.67 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
58.91

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Aditya Chopra, MD, PC CurrentSince Jan 10, 2011 Accepting new patients

Locations

600 Ridgely Ave
Ste 231
Annapolis, MD 21401
Phone (410) 266-8116

15005 Health Center Dr
Bowie, MD 20716
Phone (301) 805-6070

7600 Laurel Bowie Rd
Bowie, MD 20715
Phone (301) 317-6576

Organizations & group practices 1

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1221609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444003200000",
    "number": "1184873895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2783 AUTUMN CHASE RUN",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214017259",
            "telephone_number": "443-414-6411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6095 MARSHALEE DR",
            "city": "ELKRIDGE",
            "state": "MD",
            "postal_code": "210756053",
            "telephone_number": "410-279-3284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIETERICH",
        "first_name": "CHRISTI",
        "middle_name": "ANN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-17",
        "last_updated": "2015-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MD",
            "license": "R146251",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHRISTI",
            "last_name": "MOWERY",
            "middle_name": "ANN",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Elkridge, MD

Sources for this page

Verify at the official NPI Registry.