Individual provider Active NPI

Kerri an Mross, MD

  • Internal Medicine Physician
  • Baltimore, MD
National Provider Identifier
1295780195
Registry record updated Jun 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
D0063347 Issued in MD
Practice address
3100 Wyman Park Dr
Dept of Medicine
Baltimore, MD 21211
Phone
(410) 338-3500
NPI assigned
May 23, 2006
Last updated
Jun 5, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X D0063347 MD Primary

Addresses

Primary practice location

3100 Wyman Park Dr
Dept of Medicine
Baltimore, MD 21211

Mailing address

9910 Franklin Square Dr # 2110
Baltimore, MD 21236-4902
Phone (410) 933-5412

Other practice location 1

3100 Wyman Park Dr
Dept of Medicine
Baltimore, MD 21211-2803
Phone (410) 338-3500

Other identifiers 3

IdentifierTypeStateIssuer
408216800MedicaidMD
S189 / 0041OtherMDBLUECHOICE
KF68 / 647758-01OtherMDBC / BS OF MD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050830000677 MD Practitioner - Internal Medicine 8325079254 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Virginia Commonwealth University, School of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Johns Hopkins Community Physicians, IncGroup PAC ID 8325943707, shared by 7 NPIs, 764 clinicians

Practice addresses (Care Compare)

1000 E Eager St
E Baltimore Med Ctr
Baltimore, MD 21202-5533
Phone (410) 522-9800

2700 Remington Ave
Suite 2000
Baltimore, MD 21211-3037
Phone (667) 312-2400

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
D0063347MDMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Johns Hopkins Community Physicians Internal Medicine CurrentSince Jan 11, 2010 Accepting new patients
Johns Hopkins Community Physicians, Inc Internal Medicine CurrentSince Jan 11, 2010 Accepting new patients
Maryland Family Care, Inc. Internal Medicine CurrentSince Aug 29, 2005 Accepting new patients
Johns Hopkins Community Physicians, Inc CurrentSince Jan 11, 2010 Accepting new patients
Family Health Centers of Baltimore Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

1000 E Eager St
Baltimore, MD 21202
Phone (410) 522-9800

2700 Remington Ave
Ste 2000
Baltimore, MD 21211
Phone (667) 312-2400

3100 Wyman Park Dr
Baltimore, MD 21211
Phone (410) 338-3000

315 N Calvert St
Fl 4
Baltimore, MD 21202
Phone (410) 520-5600

7602 Belair Rd
Nottingham, MD 21236
Phone (410) 332-9654

9910 Franklin Square Dr
#2110
Nottingham, MD 21236
Phone (410) 933-5412

4224 Altamont PL Ste 201
Ste 201
White Plains, MD 20695
Phone (240) 607-1500

Interoperability endpoints

  • Direct secure messaging: kmross6882@direct.hopkinsmedicine.org

Organizations & group practices 6

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": "1148342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528156800000",
    "number": "1295780195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9910 FRANKLIN SQUARE DR # 2110",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212364902",
            "telephone_number": "410-933-5412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 WYMAN PARK DR",
            "address_2": "DEPT OF MEDICINE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "21211",
            "telephone_number": "410-338-3500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3100 Wyman Park Dr",
            "address_2": "Dept of Medicine",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212112803",
            "country_code": "US",
            "telephone_number": "410-338-3500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MROSS",
        "first_name": "KERRI AN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-23",
        "last_updated": "2018-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D0063347",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "408216800",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECHOICE",
            "identifier": "S189 / 0041",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC / BS OF MD",
            "identifier": "KF68 / 647758-01",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.