NPIMap

Individual provider Active NPI

Susan Rebecca White-Dragon, CRNP

  • Family Nurse Practitioner
  • Frederick, MD
National Provider Identifier
1295358760
Registry record updated May 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R216839 Issued in MD
Practice address
110 Baughmans LN Ste 140
Frederick, MD 21702-4649
Phone
(240) 215-1138
NPI assigned
May 19, 2020
Last updated
May 26, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 26, 2020

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 R216839 MD Primary

Addresses

Primary practice location

110 Baughmans LN Ste 140
Frederick, MD 21702-4649

Mailing address

3807 Justin Rd
Monkton, MD 21111-1813
Phone (443) 617-4181

Other names 1

  • Susan Rebecca Unfried Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200611002170 MD Practitioner - Nurse Practitioner 3971925371 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Agape Physical Therapy and Sports Rehabilitation LPGroup PAC ID 3870741390, 684 clinicians

Practice addresses (Care Compare)

12 Newport Dr
Suite a
Forest Hill, MD 21050-1758

14 A Mount Carmel Rd
Parkton, MD 21120-9721
Phone (410) 337-4877

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group, LLC Family Medicine CurrentSince May 4, 2020 Accepting new patients
University of Maryland St. Joseph Medical Group, LLC CurrentSince Oct 1, 2024 Accepting new patients
Menocal Medical Services PA Family Medicine Current Accepting new patients
Privia Care Center LLC Current Accepting new patients
Privia Care Center LLC CurrentSince May 17, 2020 Accepting new patients
University of Maryland St. Joseph Medical Group, LLC CurrentSince Oct 1, 2024 Accepting new patients
Privia Medical Group, LLC CurrentSince May 4, 2020 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

133 Defense Hwy
Ste 112
Annapolis, MD 21401
Phone (410) 573-0140

110 Baughmans Ln
Ste 140
Frederick, MD 21702
Phone (240) 215-1138

900 Elkridge Landing Rd
Fl 2
Linthicum Heights, MD 21090
Phone (443) 462-5010

14A Mount Carmel Rd
Parkton, MD 21120
Phone (410) 357-9283

7601 Osler Dr
Towson, MD 21204
Phone (410) 337-1150

11350 Pembrooke Sq
Ste 304
Waldorf, MD 20603
Phone (301) 856-2810

Interoperability endpoints

  • Direct secure messaging: sunfried326888@direct.umm.edu

Organizations & group practices 9

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1589846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590451200000",
    "number": "1295358760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3807 JUSTIN RD",
            "city": "MONKTON",
            "state": "MD",
            "postal_code": "211111813",
            "telephone_number": "443-617-4181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 BAUGHMANS LN STE 140",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217024649",
            "telephone_number": "240-215-1138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE-DRAGON",
        "first_name": "SUSAN",
        "middle_name": "REBECCA",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-19",
        "last_updated": "2020-05-26",
        "certification_date": "2020-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R216839",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUSAN",
            "last_name": "UNFRIED",
            "middle_name": "REBECCA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Frederick, MD

Sources for this page

Verify at the official NPI Registry.