Kericia Hall-Chambers, CRNP
Individual provider Active NPI Family Nurse Practitioner · Conowingo, MD
NPI 1376250910 · NPPES record last updated Apr 27, 2023
Key facts
- NPI
- 1376250910
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- R235910 (MD)
- Practice address
- 49 Rock Springs Rd
Conowingo, MD 21918-1352 - Phone
- (410) 378-9696
- Fax
- (410) 378-9922
- NPI assigned
- Nov 2, 2022
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 5
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2022
- Medicare assignment
- May accept Medicare assignment
- Group practices
- West Cecil Health Center Inc.
Practice addresses (Care Compare)
49 Rock Springs Rd
Conowingo, MD 21918-1352
Phone 41037896961130
Hospital & facility affiliations
- Union Hospital of Cecil County
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MD
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230427003118 | MD | Practitioner - Nurse Practitioner | 7214392109 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R235910 | MD | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| West Cecil Health Center Inc. | Current | Accepting new patients | |
| West Cecil Health Center Inc. | Current |
Accepting new patients | |
| West Cecil Health Center Inc. | Current |
Accepting new patients | |
| West Cecil Health Center Inc. | Current | Accepting new patients | |
| West Cecil Health Center Inc. | Past | Accepting new patients |
Locations
49 Rock Springs Rd
Conowingo, MD 21918
Phone (877) 622-8484
401 Bow St
Elkton, MD 21921
Phone (410) 996-5550
253 Lewis Ln
Ste 202
Havre de Grace, MD 21078
Phone (443) 502-7060
Interoperability endpoints
- https://api.platform.athenahealth.com/6703/brand/1/csg/1/fhir/r4
- https://fhir4.healow.com/fhir/r4/DAHIAD
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | R235910 | MD | Yes |
Addresses
Primary practice location
49 Rock Springs Rd
Conowingo, MD 21918-1352
Mailing address
PO Box 99
Conowingo, MD 21918-0099
Phone (410) 378-9696
Other providers in Conowingo, MD
- Susan Ferenz
- Tiffanie Fontaine
- Cameron Casey Gilmore
- Karen Glab-Bivens
- Dawn Marie Gomez
- Lillie Yvonne Hamilton
- Kate Hartsoe
- Steven Jay Hess
- Bernadette Diego Hipkins
- Sharon Holloway
All providers in Conowingo, MD · Family Nurse Practitioner in Maryland
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 27, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.