Individual provider Active NPI

Renee Kelling, N.P.

  • Nurse Practitioner
  • Baltimore, MD
National Provider Identifier
1316952104
Registry record updated Oct 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
R079839 Issued in MD
Practice address
22 S Greene St
Baltimore, MD 21201-1544
Phone
(410) 328-6897
Fax
(410) 328-2109
NPI assigned
Jul 30, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X R079839 MD Primary

Addresses

Primary practice location

22 S Greene St
Baltimore, MD 21201-1544

Mailing address

PO Box 64226
Baltimore, MD 21264-4742
Phone (410) 328-6897

Other identifiers 4

IdentifierTypeStateIssuer
61942101OtherMDBLUE SHIELD
0083OtherMDCAREFIRST REGIONAL
227446OtherMDKAISER
400256300MedicaidMD

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170927002061 MD Practitioner - Nurse Practitioner 4082874615 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of Maryland Anesthesiology Associates, P.a. CurrentSince Aug 1, 2017 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

22 S Greene St
Baltimore, MD 21201
Phone (410) 328-5793

419 W Redwood St
Fl 3
Baltimore, MD 21201
Phone (410) 328-5300

22 S Greene St
Bldg 7TH
Baltimore, MD 21201

611 S Charles St
Baltimore, MD 21230
Phone (410) 328-6331

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": "1154217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729555200000",
    "number": "1316952104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 64226",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212644742",
            "telephone_number": "410-328-6897",
            "fax_number": "410-328-2109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 S GREENE ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212011544",
            "telephone_number": "410-328-6897",
            "fax_number": "410-328-2109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLING",
        "first_name": "RENEE",
        "name_prefix": "Mrs.",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-30",
        "last_updated": "2024-10-22",
        "certification_date": "2024-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MD",
            "license": "R079839",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "61942101",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST REGIONAL",
            "identifier": "0083",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KAISER",
            "identifier": "227446",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "400256300",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.