Individual provider Active NPI

Angela Marie Jefferson, CRNP-F

  • Family Nurse Practitioner
  • Salisbury, MD
National Provider Identifier
1275755076
Registry record updated May 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R165285 Issued in MD
Practice address
1111 Mount Hermon Rd Ste a
Salisbury, MD 21804-5109
Phone
(410) 546-2133
Fax
(410) 548-3361
NPI assigned
May 2, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2025

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 R165285 MD Primary

Addresses

Primary practice location

1111 Mount Hermon Rd Ste a
Salisbury, MD 21804-5109

Mailing address

10200 Grand Central Ave Ste 220
Owings Mills, MD 21117-4366
Phone (410) 581-1600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DE2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20071001000190 MD Practitioner - Nurse Practitioner 4880789288 Reassigns benefits to 2 organizations
I20141219000742 DE Practitioner - Nurse Practitioner 4880789288 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Chesapeake Urology Associates LLCGroup PAC ID 4789673393, 161 clinicians

Practice addresses (Care Compare)

1111 Mount Hermon Rd
A
Salisbury, MD 21804-5109
Phone (410) 546-2133

1838 Greene Tree Rd
Suite 460
Baltimore, MD 21208-7113
Phone (410) 581-8140

220 Pennsylvania Ave
Seaford, DE 19973-3820
Phone (410) 581-1600

314 Franklin Ave
Suite 302
Berlin, MD 21811-1238
Phone (410) 641-3735

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R165285MDMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Chesapeake Urology Associates, LLC CurrentSince Apr 1, 2018 Accepting new patients
Freedom Healthcare, LLC CurrentSince Jan 1, 2014 Accepting new patients
Chesapeake Urology Associates, LLC Current Accepting new patients

Locations

1119 E Monument St
Baltimore, MD 21202
Phone (443) 705-5056

3310 Eastern Ave
Baltimore, MD 21224
Phone (443) 708-5056

314 Franklin Ave
Ste 302
Berlin, MD 21811
Phone (410) 641-0430

10200 Grand Central Ave
Ste 220
Owings Mills, MD 21117

25 Crossroads Dr
Ste 306
Owings Mills, MD 21117
Phone (443) 231-1681

1111 Mount Hermon Rd
#A
Salisbury, MD 21804
Phone (410) 546-2133

1111 Mount Hermon Rd
Ste A
Salisbury, MD 21804
Phone (410) 546-2133

Interoperability endpoints

  • Direct secure messaging: angelajefferson@tsicua.allscriptsdirect.net

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1178064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748476800000",
    "number": "1275755076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10200 GRAND CENTRAL AVE STE 220",
            "city": "OWINGS MILLS",
            "state": "MD",
            "postal_code": "211174366",
            "telephone_number": "410-581-1600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 MOUNT HERMON RD STE A",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218045109",
            "telephone_number": "410-546-2133",
            "fax_number": "410-548-3361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEFFERSON",
        "first_name": "ANGELA",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "CRNP-F",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-02",
        "last_updated": "2025-05-29",
        "certification_date": "2025-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R165285",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salisbury, MD

Sources for this page

Verify at the official NPI Registry.