Active NPI
Andrea Dirks
- Nurse Practitioner
- Baltimore, MD
National Provider Identifier
1356043277
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- R245538
- Practice address
- 825 S Charles St
Baltimore, MD 21230-3938 - Phone
- (410) 698-2215
- NPI assigned
- Mar 22, 2023
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | R245538 | MD | Primary |
Addresses
Primary practice location
825 S Charles St
Baltimore, MD 21230-3938
Mailing address
825 S Charles St
Baltimore, MD 21230-3938
Other names 1
- Andrea Gilliland
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1833 Forest Dr
Suite a
Annapolis, MD 21401-4580
Phone (410) 216-9180
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R245538 | MD | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Living Health Integrative Medicine LLC | Current | Accepting new patients |
Locations
1833 Forest Dr
Ste A
Annapolis, MD 21401
Phone (410) 216-9180
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.
-
- Physical Medicine & Rehabilitation Physician
- Annapolis, MD
- NPI 1184963217
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1679443200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1679443200000",
"number": "1356043277",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "825 S CHARLES ST",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212303938"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "825 S CHARLES ST",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212303938",
"telephone_number": "410-698-2215"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIRKS",
"first_name": "ANDREA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-03-22",
"last_updated": "2023-03-22",
"certification_date": "2023-03-22",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "MD",
"license": "R245538",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "ANDREA",
"last_name": "GILLILAND",
"code": "1",
"type": "Former Name"
}
]
}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 22, 2023; 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.