Individual provider Active NPI

Courtney Anne Beeckler, CRNP

  • Gerontology Nurse Practitioner
  • Baltimore, MD
National Provider Identifier
1376033472
Registry record updated Feb 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
R209779 Issued in MD
Practice address
401 N Broadway St Ste 1440
Baltimore, MD 21287-0019
Phone
(410) 614-0003
NPI assigned
May 14, 2018
Last updated
Feb 2, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X R209779 MD Primary

Addresses

Primary practice location

401 N Broadway St Ste 1440
Baltimore, MD 21287-0019

Mailing address

401 N Broadway St Ste 1440
Baltimore, MD 21287-0019
Phone (410) 614-0003

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R209779MDMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Johns Hopkins University CurrentSince Oct 22, 2018 Accepting new patients
Johns Hopkins University CurrentSince Oct 22, 2018 Accepting new patients
Johns Hopkins University Current Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

600 N Wolfe St
Baltimore, MD 21287

6201 Greenleigh Ave
Middle River, MD 21220
Phone (410) 933-2704

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": "1526256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612224000000",
    "number": "1376033472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 N BROADWAY ST STE 1440",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212870019",
            "telephone_number": "410-614-0003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 N BROADWAY ST STE 1440",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212870019",
            "telephone_number": "410-614-0003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEECKLER",
        "first_name": "COURTNEY",
        "middle_name": "ANNE",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-14",
        "last_updated": "2021-02-02",
        "certification_date": "2021-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MD",
            "license": "R209779",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.