Active NPI
John W Distler, FNP
- Family Nurse Practitioner
- Westminster, MD
National Provider Identifier
1285692418
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- R147365
- Practice address
- 844 Washington Road
Suite 201
Westminster, MD 21157-3035 - Phone
- (410) 857-7900
- Fax
- (410) 857-1150
- NPI assigned
- May 4, 2006
- Last updated
- May 30, 2012
- Sex
- Male
- 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 | R147365 | MD | Primary |
Addresses
Primary practice location
844 Washington Road
Suite 201
Westminster, MD 21157-3035
Mailing address
2800 Quarry Lake Drive
100
Baltimore, MD 21209-3770
Phone (410) 486-2000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 097702100 | Medicaid | MD |
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
| License | State | Type | Specialty |
|---|---|---|---|
| R147365 | MD | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Frederick Health Hospital Inc | Past | Accepting new patients | |
| Yardmore Emergency Physicians LLC | Past | Accepting new patients | |
| United Health Services Hospitals, Inc. | Past | Accepting new patients |
Organizations & group practices 3
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.
-
dba Frederick Health Hospital
- General Acute Care Hospital
- Frederick, MD
- NPI 1538165527
-
- Emergency Medicine Physician
- Baltimore, MD
- NPI 1730131657
-
- Multi-Specialty Clinic/Center
- Johnson City, NY
- NPI 1962463851
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146700800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1338336000000",
"number": "1285692418",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2800 QUARRY LAKE DRIVE",
"address_2": "100",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212093770",
"telephone_number": "410-486-2000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "844 WASHINGTON ROAD",
"address_2": "SUITE 201",
"city": "WESTMINSTER",
"state": "MD",
"postal_code": "211573035",
"telephone_number": "410-857-7900",
"fax_number": "410-857-1150"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DISTLER",
"first_name": "JOHN",
"middle_name": "W",
"credential": "FNP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-04",
"last_updated": "2012-05-30",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "MD",
"license": "R147365",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "097702100",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Westminster, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.