Jeannette Kay Nussbaum, R.N.

Primary specialty

SpecialistTaxonomy code 174400000X

License

R078947 Issued in MD

Practice address

8759 Stonehouse Drive
Ellicott City, MD 21043-1912

Phone

(410) 465-7548

Fax

(410) 465-8471

NPI assigned

Jun 2, 2010

Last updated

Jun 2, 2010By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

Practice roles

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.

• Proactive Medical Consultants LLC

  • Case Management Agency
  • Ellicott City, MD
  • NPI 1477074797
  NPD (past) Authorized official

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

{
    "created_epoch": "1275436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1275436800000",
    "number": "1215257159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8759 STONEHOUSE DRIVE",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210431912",
            "telephone_number": "410-465-7548",
            "fax_number": "410-465-8471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8759 STONEHOUSE DRIVE",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210431912",
            "telephone_number": "410-465-7548",
            "fax_number": "410-465-8471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NUSSBAUM",
        "first_name": "JEANNETTE",
        "middle_name": "KAY",
        "name_prefix": "Ms.",
        "credential": "R.N.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-06-02",
        "last_updated": "2010-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MD",
            "license": "R078947",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WCCM",
            "identifier": "G1157",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Novus Pain Management - Maryland, LLC
• Ntiege Ntiege Kang, PHARMACIST
• Nugahealth Primary Care LLC
• Frederick Nepomuceno Nuguid, PT
• Aaliyah Nurideen
• Nutrids, LLC
• Charles U Nwachukwu
• Nicole Adanna Nwandu
• Melanie Powers Nystrom, MA, NBC-HWC
• Michael J O'Connell, PH.D.

• Specialist in Ellicott City, MD
• Providers in Ellicott City, MD by specialty
• Specialist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2010; 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.