Individual provider Active NPI

Sara Ann Ravenscraft, FNP-BC

  • Family Nurse Practitioner
  • Columbia, MD
National Provider Identifier
1215670518
Registry record updated Apr 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2021162166 Issued in WI
Practice address
10175 Little Patuxent Pkwy
Columbia, MD 21044-2655
Phone
(800) 561-0861
NPI assigned
Apr 15, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 2021162166 WI Primary

Addresses

Primary practice location

10175 Little Patuxent Pkwy
Columbia, MD 21044-2655

Mailing address

5408 Center LN
Waterford, WI 53185-2938
Phone (262) 894-9480

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

State licenses

LicenseStateTypeSpecialty
2021162166WIMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1649980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649980800000",
    "number": "1215670518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5408 CENTER LN",
            "city": "WATERFORD",
            "state": "WI",
            "postal_code": "531852938",
            "telephone_number": "262-894-9480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10175 LITTLE PATUXENT PKWY",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210442655",
            "telephone_number": "800-561-0861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAVENSCRAFT",
        "first_name": "SARA",
        "middle_name": "ANN",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-15",
        "last_updated": "2022-04-15",
        "certification_date": "2022-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "2021162166",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2022; 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.