Carol Susan Thelen, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

R196699 Issued in MD

Practice address

1700 Reisterstown Rd
Suite 214
Baltimore, MD 21208-1416

Phone

(410) 486-8303

NPI assigned

Aug 23, 2013

Last updated

Aug 23, 2013By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MD, VA2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Nurse Practitioner

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Johnson Health CenterGroup PAC ID 9537060413, shared by 5 NPIs, 39 clinicians

Maryland Family Care IncGroup PAC ID 5092629394, 157 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Maryland Family Care, Inc.

  • Family Medicine Physician
  • Baltimore, MD
  • NPI 1598718256

  Nurse Practitioner

  Medicare reassignment Care Compare group NPD
• Lifebridge Community Physicians, Inc

  • Cardiovascular Disease Physician
  • Timonium, MD
  • NPI 1174815807
  Medicare reassignment NPD
• Johnson Health Center

  • Federally Qualified Health Center (FQHC)
  • Lynchburg, VA
  • NPI 1316926538
  Medicare reassignment NPD
• Johnson Health Center

  dba Rustburg Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Rustburg, VA
  • NPI 1881102655
  Medicare reassignment NPD
• Lifebridge Community Physicians Inc

  • Cardiovascular Disease Physician
  • Lutherville, MD
  • NPI 1740086149
  NPD
• Lifebridge Community Physicians, Inc.

  dba Dr. Usman Waheed

  • Surgery Physician
  • Randallstown, MD
  • NPI 1336684505
  NPD
• Johnson Health Center

  dba Amherst County Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Madison Heights, VA
  • NPI 1972858660
  NPD
• Frederick Health Hospital Inc

  dba Frederick Health Hospital

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)
• Homecentris Community Care, LLC

  • Community Health Clinic/Center
  • Owings Mills, MD
  • NPI 1528477809
  NPD (past)
• Johnson Health Center

  dba Lynchburg Women's and Pediatric Health Services

  • Federally Qualified Health Center (FQHC)
  • Lynchburg, VA
  • NPI 1821212481
  NPD (past)

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

{
    "created_epoch": "1377216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377216000000",
    "number": "1316371552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 REISTERSTOWN RD",
            "address_2": "SUITE 214",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212081416",
            "telephone_number": "410-486-8303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 REISTERSTOWN RD",
            "address_2": "SUITE 214",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212081416",
            "telephone_number": "410-486-8303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THELEN",
        "first_name": "CAROL",
        "middle_name": "SUSAN",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-08-23",
        "last_updated": "2013-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MD",
            "license": "R196699",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• The Wellthy Living Project, LLC
• Christiane Theda, M.D.
• Sheryl Elaine Thedford, PHD, PHARMD, BCPS
• Mya S Thein, M.D.
• Jason Theis, MD, MPH
• Samalya Damsari Thenuwara, BS
• Melissa Theodore, JD., M.ED, BCBA
• Nicholas Theodore, MD
• Dana Lynn Theodoropoulos, CRNP
• Christian Theodosis, MD

• Nurse Practitioner in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2013; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.