Individual provider Active NPI

Jameel Anderson, DNP

  • Family Nurse Practitioner
  • Columbia, MD
National Provider Identifier
1366272155
Registry record updated Aug 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R213800 Issued in MD
Practice address
5890 Waterloo Rd
Columbia, MD 21045-2617
Phone
(667) 214-2100
NPI assigned
Aug 6, 2024
Last updated
Aug 7, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2024

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 R213800 MD Primary

Addresses

Primary practice location

5890 Waterloo Rd
Columbia, MD 21045-2617

Mailing address

206 Seamaster Rd
Baltimore, MD 21221-5962
Phone (410) 274-2416

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
I20240924004804 MD Practitioner - Nurse Practitioner 7911448428 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

29 S Paca St
Baltimore, MD 21201-1771
Phone (667) 214-2100

408 W Lombard St
Baltimore, MD 21201-1601
Phone (667) 214-2100

5890 Waterloo Rd
Columbia, MD 21045-2617
Phone (667) 214-2100

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of Maryland Family Medicine Associates, P.a. Current Accepting new patients
University of Maryland Family Medicine Associates, P.a. CurrentSince Sep 30, 2024 Accepting new patients
University of Maryland Family Medicine Associates, P.a. CurrentSince Sep 30, 2024 Accepting new patients
University of Maryland Faculty Physicians Immediate Care, LLC CurrentSince Sep 30, 2024 Accepting new patients

Locations

250 W Pratt St
Ste 900
Baltimore, MD 21201
Phone (410) 328-6267

408 W Lombard St
Baltimore, MD 21201
Phone (667) 214-1899

5890 Waterloo Rd
Columbia, MD 21045
Phone (410) 328-2603

Interoperability endpoints

  • Direct secure messaging: janderson475278@direct.umm.edu

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1722902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722988800000",
    "number": "1366272155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 SEAMASTER RD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212215962",
            "telephone_number": "410-274-2416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5890 WATERLOO RD",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210452617",
            "telephone_number": "667-214-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "JAMEEL",
        "credential": "DNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-08-06",
        "last_updated": "2024-08-07",
        "certification_date": "2024-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R213800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MD

Sources for this page

Verify at the official NPI Registry.