Individual provider Active NPI

Libra Robertson, CRNP

  • Family Nurse Practitioner
  • Towson, MD
National Provider Identifier
1215434584
Registry record updated May 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R208116 Issued in MD
Practice address
100 E Pennsylvania Ave Ste 304
Towson, MD 21286-0701
Phone
(410) 498-4808
Fax
(410) 498-7244
NPI assigned
Apr 12, 2018
Last updated
May 22, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R208116 MD Primary
Primary Care Nurse Practitioner 363LP2300X R208116 MD
Registered Nurse 163W00000X R208116 MD

Addresses

Primary practice location

100 E Pennsylvania Ave Ste 304
Towson, MD 21286-0701

Mailing address

6405 Chessington St
Middle River, MD 21220-1857
Phone (443) 743-8129

Other practice location 1

4419 Falls Rd Ste A
Baltimore, MD 21211-1298
Phone (410) 366-1101

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)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R208116MDMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Loveli Care Services CurrentSince May 26, 2024 Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1523491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716336000000",
    "number": "1215434584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6405 CHESSINGTON ST",
            "city": "MIDDLE RIVER",
            "state": "MD",
            "postal_code": "212201857",
            "telephone_number": "443-743-8129",
            "fax_number": "410-498-7244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E PENNSYLVANIA AVE STE 304",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212860701",
            "telephone_number": "410-498-4808",
            "fax_number": "410-498-7244"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4419 Falls Rd Ste A",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212111298",
            "country_code": "US",
            "telephone_number": "410-366-1101",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROBERTSON",
        "first_name": "LIBRA",
        "name_prefix": "Ms.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-12",
        "last_updated": "2024-05-22",
        "certification_date": "2024-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R208116",
            "primary": true
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MD",
            "license": "R208116",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MD",
            "license": "R208116",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Towson, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2024; 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.