Active NPI
Jennifer Sue Small, CRNP
- Family Nurse Practitioner
- Rockville, MD
National Provider Identifier
1285978106
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- R178162
- Practice address
- 9715 Medical Center Dr
#501
Rockville, MD 20850-3320 - Phone
- (301) 738-0300
- Fax
- (301) 738-1316
- NPI assigned
- Nov 15, 2012
- Last updated
- Nov 15, 2012
- 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 | R178162 | MD | Primary |
Addresses
Primary practice location
9715 Medical Center Dr
#501
Rockville, MD 20850-3320
Mailing address
9715 Medical Center Dr
#501
Rockville, MD 20850-3320
Phone (301) 738-0300
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in DC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160421002089 | DC | Order and Referring Only - Nurse Practitioner | 4486953684 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Frederick Health Hospital Inc | Past | Accepting new patients |
Organizations & group practices 1
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1352937600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1352937600000",
"number": "1285978106",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9715 MEDICAL CENTER DR",
"address_2": "#501",
"city": "ROCKVILLE",
"state": "MD",
"postal_code": "208503320",
"telephone_number": "301-738-0300",
"fax_number": "301-738-1316"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9715 MEDICAL CENTER DR",
"address_2": "#501",
"city": "ROCKVILLE",
"state": "MD",
"postal_code": "208503320",
"telephone_number": "301-738-0300",
"fax_number": "301-738-1316"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMALL",
"first_name": "JENNIFER",
"middle_name": "SUE",
"credential": "CRNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-11-15",
"last_updated": "2012-11-15",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "MD",
"license": "R178162",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rockville, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2012; 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.