Individual provider Active NPI

Mary Ann Justice, RN

  • Community Health Registered Nurse
  • Berlin, MD
National Provider Identifier
1265518211
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health Registered NurseTaxonomy code 163WC1500X
License
R079229 Issued in MD
Practice address
Berlin Health Center
9730 Healthway Drive
Berlin, MD 21811
Phone
(410) 629-0164
Fax
(410) 629-0185
NPI assigned
Oct 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Registered Nurse 163WC1500X R079229 MD Primary

Addresses

Primary practice location

Berlin Health Center
9730 Healthway Drive
Berlin, MD 21811

Mailing address

1404 Whittier Dr
Salisbury, MD 21801-3243
Phone (410) 860-4733

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
R079229MDMDCommunity Health Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1162252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1265518211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1404 WHITTIER DR",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218013243",
            "telephone_number": "410-860-4733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BERLIN HEALTH CENTER",
            "address_2": "9730 HEALTHWAY DRIVE",
            "city": "BERLIN",
            "state": "MD",
            "postal_code": "21811",
            "telephone_number": "410-629-0164",
            "fax_number": "410-629-0185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUSTICE",
        "first_name": "MARY",
        "middle_name": "ANN",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC1500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Community Health",
            "state": "MD",
            "license": "R079229",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berlin, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.