Active NPI
Dathao Huynh
- Family Nurse Practitioner
- Ellicott City, MD
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- R225185
- Practice address
- 4801 Dorsey Hall Dr Ste 140
Ellicott City, MD 21042-7703 - Phone
- (410) 992-4100
- NPI assigned
- Feb 27, 2020
- Last updated
- Feb 27, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | R225185 | MD | Primary |
Addresses
Primary practice location
4801 Dorsey Hall Dr Ste 140
Ellicott City, MD 21042-7703
Mailing address
9716 Summer Park CT
Columbia, MD 21046-1808
Phone (609) 892-5972
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MD
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R225185 | MD | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Medical and Aesthetic Dermatology | Current | Accepting new patients | |
| Lauring Dermatology LLC | Current | Accepting new patients | |
| Wellave, LLC | Current | Accepting new patients | |
| Privia Care Center LLC | Past | Accepting new patients | |
| Frederick Health Hospital Inc | Past | Accepting new patients |
Locations
116 Defense Hwy
Ste 102
Annapolis, MD 21401
Phone (410) 897-1961
9256 Bendix Rd
Ste 200A
Columbia, MD 21045
Phone (443) 201-1603
198 Thomas Johnson Dr
Ste 8
Frederick, MD 21702
Phone (301) 663-8707
415 Williams Ct
Ste 116
Middle River, MD 21220
Phone (410) 665-3093
7642 Belair Rd
Nottingham, MD 21236
Phone (410) 665-3093
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/HFJEBA
Organizations & group practices 5
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.
-
- Specialist
- Nottingham, MD
- NPI 1881059236
-
- Dermatology Physician
- Columbia, MD
- NPI 1720364227
-
- Medical Specialty Clinic/Center
- Frederick, MD
- NPI 1891159661
-
dba Frederick Health Hospital
- General Acute Care Hospital
- Frederick, MD
- NPI 1538165527
-
- Internal Medicine Physician
- Arlington, VA
- NPI 1164874426
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1582761600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1582761600000",
"number": "1285268300",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9716 SUMMER PARK CT",
"city": "COLUMBIA",
"state": "MD",
"postal_code": "210461808",
"telephone_number": "609-892-5972"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4801 DORSEY HALL DR STE 140",
"city": "ELLICOTT CITY",
"state": "MD",
"postal_code": "210427703",
"telephone_number": "410-992-4100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HUYNH",
"first_name": "DATHAO",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-02-27",
"last_updated": "2020-02-27",
"certification_date": "2020-02-27",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "MD",
"license": "R225185",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Ellicott City, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.