Active NPI
Norman A Poulsen, MD
- Family Medicine Physician
- Odenton, MD
National Provider Identifier
1306940671
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- D20645
- Practice address
- 1132 Annapolis Rd
Odenton, MD 21113 - Phone
- (410) 874-1400
- Fax
- (410) 874-1411
- NPI assigned
- Sep 8, 2006
- Sex
- Male
- 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 Medicine Physician | 207Q00000X | D20645 | MD | Primary |
Addresses
Primary practice location
1132 Annapolis Rd
Odenton, MD 21113
Mailing address
3100 Wyman Park Dr
Ste 359a
Baltimore, MD 21211
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 189101400 | Medicaid | MD |
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
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D20645 | MD | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Johns Hopkins Community Physicians, Inc | Family Medicine | 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 and National Provider Directory roles.
-
- Family Medicine Physician
- Baltimore, MD
- NPI 1770518003
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157673600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1368057600000",
"number": "1306940671",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3100 WYMAN PARK DR",
"address_2": "STE 359A",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "21211"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1132 ANNAPOLIS RD",
"city": "ODENTON",
"state": "MD",
"postal_code": "21113",
"telephone_number": "410-874-1400",
"fax_number": "410-874-1411"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POULSEN",
"first_name": "NORMAN",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-08",
"last_updated": "2013-05-09",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MD",
"license": "D20645",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "189101400",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}Other providers in Odenton, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.