Individual provider Active NPI

Venessa K Richards-Clarke

  • Family Nurse Practitioner
  • Nottingham, MD
National Provider Identifier
1356919765
Registry record updated Jun 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AC003734 Issued in MD
Practice address
5230 Campbell Blvd
Nottingham, MD 21236-4983
Phone
(866) 389-2727
NPI assigned
Jun 12, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AC003734 MD Primary

Addresses

Primary practice location

5230 Campbell Blvd
Nottingham, MD 21236-4983

Mailing address

5230 Campbell Blvd
Nottingham, MD 21236-4983

Other practice location 1

7795 Davis Blvd Ste 206B
Naples, FL 34104-5373
Phone (954) 536-9867

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 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

Enrollment IDStateProvider typePAC IDDetails
I20220630002893 MD Practitioner - Nurse Practitioner 1759761125 Reassigns benefits to 1 organization
I20220706001513 DC Practitioner - Nurse Practitioner 1759761125 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MNR Industries, LLCGroup PAC ID 7416908843, 142 clinicians

Practice addresses (Care Compare)

1307 Merritt Blvd
Dundalk, MD 21222-2109
Phone (410) 288-2121

1354 Eastern Blvd
Expresscare of Essex
Essex, MD 21221-3423
Phone (443) 231-5203

1470 Martin Blvd
Middle River, MD 21220-4105
Phone (443) 231-5203

1505 E Churchville Rd
Bel Air, MD 21014-4742

2401 E Belvedere Ave
Baltimore, MD 21215-5216

4009 N Point Blvd
105 Expresscare of North Point
Dundalk, MD 21222-3619
Phone (410) 477-1039

7700 Belair Rd
Baltimore, MD 21236-4004
Phone (410) 665-0670

7701 Harford Rd
Parkville, MD 21234-6403
Phone (410) 569-0069

8000 Loch Raven Blvd
Loch Raven, MD 21286-8337
Phone (410) 616-9027

9832 York Rd
Suite F
Cockeysville, MD 21030-4936
Phone (410) 628-1861

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AC003734MDMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
MNR Industries, LLC Current Accepting new patients
MNR Industries LLC Current Accepting new patients
MNR Industries, LLC CurrentSince Sep 1, 2023 Accepting new patients
MNR Industries LLC CurrentSince Sep 1, 2023 Accepting new patients
MNR Industries, LLC CurrentSince Sep 1, 2023 Accepting new patients
MNR Industries, LLC Current Accepting new patients

Locations

1505 E Churchville Rd
Bel Air, MD 21014
Phone (410) 420-6970

1505 E Churchville Rd
#A
Bel Air, MD 21014
Phone (410) 420-6970

6000 Laurel Bowie Rd
Bowie, MD 20715
Phone (301) 383-0330

504 E Ridgeville Blvd
#A
Mount Airy, MD 21771
Phone (301) 703-5452

Organizations & group practices 6

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": "1623456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654214400000",
    "number": "1356919765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5230 CAMPBELL BLVD",
            "city": "NOTTINGHAM",
            "state": "MD",
            "postal_code": "212364983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5230 CAMPBELL BLVD",
            "city": "NOTTINGHAM",
            "state": "MD",
            "postal_code": "212364983",
            "telephone_number": "866-389-2727"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7795 Davis Blvd Ste 206B",
            "address_purpose": "LOCATION",
            "city": "Naples",
            "state": "FL",
            "postal_code": "341045373",
            "country_code": "US",
            "telephone_number": "954-536-9867",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RICHARDS-CLARKE",
        "first_name": "VENESSA",
        "middle_name": "K",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-12",
        "last_updated": "2022-06-03",
        "certification_date": "2022-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "AC003734",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nottingham, MD

Sources for this page

Verify at the official NPI Registry.