NPIMap

Organization Active NPI

Johns Hopkins University

Doing business as JHU Medicine Nephrology

  • Nephrology Physician
  • Baltimore, MD
National Provider Identifier
1376537456
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
Legal business name
JOHNS HOPKINS UNIVERSITY
Doing business as
JHU Medicine Nephrology
Jhu-Medicine/Neprhology
Practice address
600 N Wolfe Street
Baltimore, MD 21287-0005
Phone
(410) 558-5218
NPI assigned
Sep 6, 2005
Reactivated
Mar 11, 2008
Last updated
Jul 21, 2022By the provider in NPPES
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
Nephrology Physician 207RN0300X MD Primary

Addresses

Primary practice location

600 N Wolfe Street
Baltimore, MD 21287-0005

Mailing address

PO Box 64264
Baltimore, MD 21264-4264
Phone (410) 933-4397

Other identifiers 3

IdentifierTypeStateIssuer
766561000MedicaidMD
017863052MedicaidDC
CD2563OtherMDRRMC

Other names 2

  • JHU Medicine Nephrology Doing business as
  • JHU-MEDICINE/NEPRHOLOGY 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
O20140814000211 DC Part B Supplier - Clinic/Group Practice 4981745098 Receives reassigned benefits from 5 practitioners
Practice locations: Bethesda, MD; Washington, DC

National Provider Directory

National Provider Directory
Part of
John Hopkins Univ

Practitioners & affiliated clinicians

Practitioners 116

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 116

NPI Registry JSON

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

{
    "created_epoch": "1125964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1376537456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 64264",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212644264",
            "telephone_number": "410-933-4397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 N WOLFE STREET",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212870005",
            "telephone_number": "410-558-5218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHNS HOPKINS UNIVERSITY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "JOHNS HOPKINS UNIVERSITY",
        "enumeration_date": "2005-09-06",
        "last_updated": "2022-07-21",
        "certification_date": "2021-03-08",
        "deactivation_date": "2008-02-22",
        "reactivation_date": "2008-03-11",
        "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": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "MD",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "766561000",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "017863052",
            "state": "DC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RRMC",
            "identifier": "CD2563",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "JHU Medicine Nephrology",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "JHU-MEDICINE/NEPRHOLOGY",
            "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.