Individual provider Active NPI

Mariana Azevedo Fragelli, RN

  • Registered Nurse
  • Baltimore, MD
National Provider Identifier
1336437532
Registry record updated Jul 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
R171810 Issued in MD
Practice address
2411 Crest Rd
Baltimore, MD 21209-4233
Phone
(570) 436-6151
NPI assigned
Jul 21, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X R171810 MD Primary

Addresses

Primary practice location

2411 Crest Rd
Baltimore, MD 21209-4233

Mailing address

2411 Crest Rd
Baltimore, MD 21209-4233
Phone (570) 436-6151

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)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
R171810MDMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1311206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311206400000",
    "number": "1336437532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2411 CREST RD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212094233",
            "telephone_number": "570-436-6151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2411 CREST RD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212094233",
            "telephone_number": "570-436-6151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRAGELLI",
        "first_name": "MARIANA",
        "middle_name": "AZEVEDO",
        "name_prefix": "Miss",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-21",
        "last_updated": "2011-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MD",
            "license": "R171810",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.