NPIMap

Organization Active NPI

Johns Hopkins University

  • Pediatric Nephrology Physician
  • Baltimore, MD
National Provider Identifier
1376530808
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nephrology PhysicianTaxonomy code 2080P0210X
Legal business name
JOHNS HOPKINS UNIVERSITY
Practice address
600 N Wolfe St
Baltimore, MD 21287-0005
Phone
(410) 933-1182
NPI assigned
Sep 30, 2005
Organization subpart
Yes
Parent organization
JOHNS HOPKINS UNIVERSITYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Shavonda L Keating
Title
Sr Production Unit MGR
Phone
(410) 933-6430

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nephrology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2080P0210X MD Primary

Addresses

Primary practice location

600 N Wolfe St
Baltimore, MD 21287-0005

Mailing address

PO Box 64316
Baltimore, MD 21264-4316

Other identifiers 2

IdentifierTypeStateIssuer
405101700MedicaidMD
CD6085OtherMDRRMC

Other names 1

  • JHU -PEDIATRICS/NEPHROLOGY Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031215000719 MD Part B Supplier - Clinic/Group Practice 8921903147 Receives reassigned benefits from 4,764 practitioners
This NPI is an additional NPI on the enrollment
O20181219001576 DC Part B Supplier - Hospital Department(S) 1052223229 Receives reassigned benefits from 6 practitioners
3 other NPIs on this enrollment
Practice locations: Bethesda, MD

Other NPIs with the same Medicare PAC ID 22

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 22

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Johns Hopkins Univ Emer439 organizations share this tax ID, including this one
Part of
Johns Hopkins Univ Emer

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Member organizations 24

Organizations listed as members of this organization in the National Provider Directory.

View all 24

Locations

200 N Wolfe St
Baltimore, MD 21287
Phone (410) 614-3917

Practitioners & affiliated clinicians

Practitioners 209

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 209

NPI Registry JSON

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

{
    "created_epoch": "1128038400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1376530808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 64316",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212644316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 N WOLFE ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212870005",
            "telephone_number": "410-933-1182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHNS HOPKINS UNIVERSITY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "JOHNS HOPKINS UNIVERSITY",
        "enumeration_date": "2005-09-30",
        "last_updated": "2022-07-21",
        "certification_date": "2021-03-07",
        "status": "A",
        "authorized_official_last_name": "KEATING",
        "authorized_official_first_name": "SHAVONDA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "SR PRODUCTION UNIT MGR",
        "authorized_official_telephone_number": "410-933-6430"
    },
    "taxonomies": [
        {
            "code": "2080P0210X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Pediatric Nephrology",
            "state": "MD",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "405101700",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RRMC",
            "identifier": "CD6085",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "JHU -PEDIATRICS/NEPHROLOGY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "JHU -PEDIATRICS/NEPHROLOGY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.