Individual provider Active NPI

Rachel Spar, CRNP

  • Pediatric Nurse Practitioner
  • Baltimore, MD
National Provider Identifier
1295048510
Registry record updated Nov 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
R180009 Issued in MD
Practice address
733 W 40TH St Ste LL10
Baltimore, MD 21211-2112
Phone
(410) 243-8632
Fax
(410) 243-0470
NPI assigned
Jul 15, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X R180009 MD Primary

Addresses

Primary practice location

733 W 40TH St Ste LL10
Baltimore, MD 21211-2112

Mailing address

733 W 40TH St Ste LL10
Baltimore, MD 21211-2112
Phone (410) 243-8632

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)
Not enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R180009MDMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Family Time Pediatrics, LLC CurrentSince Nov 17, 2024 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

711 W 40th St
Ste 438
Baltimore, MD 21211
Phone (410) 243-8632

733 W 40th St
Ste LL10
Baltimore, MD 21211
Phone (410) 243-8632

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1279152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730505600000",
    "number": "1295048510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "733 W 40TH ST STE LL10",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212112112",
            "telephone_number": "410-243-8632",
            "fax_number": "410-243-0470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "733 W 40TH ST STE LL10",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212112112",
            "telephone_number": "410-243-8632",
            "fax_number": "410-243-0470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPAR",
        "first_name": "RACHEL",
        "name_prefix": "Mrs.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-15",
        "last_updated": "2024-11-02",
        "certification_date": "2024-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MD",
            "license": "R180009",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2024; 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.