Organization Active NPI

Emerald Spring Clinics

  • Primary Care Nurse Practitioner
  • Baltimore, MD
National Provider Identifier
1356000947
Registry record updated Mar 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
Legal business name
EMERALD SPRING CLINICS
Practice address
405 N Paca St FL 1
Baltimore, MD 21201-1815
Phone
(410) 779-9609
Fax
(443) 552-4758
NPI assigned
Dec 11, 2021
Last updated
Mar 8, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2024

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

Authorized official

Name
Ebere Nduka, CRNPNPI 1063987063
Title
Family Nurse Practitioner (FNP)
Phone
(410) 660-9262

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X Primary

Addresses

Primary practice location

405 N Paca St FL 1
Baltimore, MD 21201-1815

Mailing address

48 Winters LN
Catonsville, MD 21228-4437
Phone (410) 660-9262

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220214001811 MD Part B Supplier - Clinic/Group Practice 2961895065 Receives reassigned benefits from 1 practitioner
Practice locations: Catonsville, MD

National Provider Directory

National Provider Directory

Locations

48 Winters Ln
Catonsville, MD 21228
Phone (410) 660-9262

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1639180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709856000000",
    "number": "1356000947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "48 WINTERS LN",
            "city": "CATONSVILLE",
            "state": "MD",
            "postal_code": "212284437",
            "telephone_number": "410-660-9262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 N PACA ST FL 1",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212011815",
            "telephone_number": "410-779-9609",
            "fax_number": "443-552-4758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMERALD SPRING CLINICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-11",
        "last_updated": "2024-03-08",
        "certification_date": "2024-03-08",
        "status": "A",
        "authorized_official_last_name": "NDUKA",
        "authorized_official_first_name": "EBERE",
        "authorized_official_title_or_position": "FAMILY NURSE PRACTITIONER (FNP)",
        "authorized_official_telephone_number": "410-660-9262",
        "authorized_official_credential": "CRNP"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": null,
            "license": null,
            "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 Mar 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.