Christine B. Bassett-Jellema, CRNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

R089354 Issued in MD

Practice address

345 St. Paul Place
Department of Pediatrics
Baltimore, MD 21202

Phone

(410) 332-9594

NPI assigned

Sep 19, 2012

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

• Christine Moore Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Interoperability endpoints

• Direct secure messaging: cmoore36304@direct.mdmercy.com

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

{
    "created_epoch": "1348012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562889600000",
    "number": "1215287065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 ST. PAUL PLACE",
            "address_2": "MEDICAL STAFF OFFICE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "21202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "345 ST. PAUL PLACE",
            "address_2": "DEPARTMENT OF PEDIATRICS",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "21202",
            "telephone_number": "410-332-9594"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASSETT-JELLEMA",
        "first_name": "CHRISTINE",
        "middle_name": "B.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-19",
        "last_updated": "2019-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MD",
            "license": "R089354",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHRISTINE",
            "last_name": "MOORE",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Sahra Bassami
• Manbir Singh Bassan, M.B.B.S
• Michael J Bassan, DC
• Howard Scott Bassel, MD
• Christie Basseth, M.D.
• Susan Spear Bassett, PH.D.
• Naresh Bassi, M.D.
• Kirolos Bassile, DMD
• Holly Bassler, LMSW
• Gregory Ashton Bassmann, MD

• Pediatric Nurse Practitioner in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Pediatric Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2019; 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.