Individual provider Active NPI

John W Distler, FNP

  • Family Nurse Practitioner
  • Westminster, MD
National Provider Identifier
1285692418
Registry record updated May 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R147365 Issued in MD
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, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 30, 2012

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 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

IdentifierTypeStateIssuer
097702100MedicaidMD

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

LicenseStateTypeSpecialty
R147365MDMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew 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.

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.

Verify at the official NPI Registry.