Individual provider Active NPI

Nicole C Humphreys, CRNP

  • Nurse Practitioner
  • Annapolis, MD
National Provider Identifier
1386508638
Registry record updated Dec 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
R169473 Issued in MD
Practice address
2002 Medical Pkwy Ste 500
Annapolis, MD 21401-3268
Phone
(410) 573-6480
NPI assigned
Dec 11, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X R169473 MD Primary

Addresses

Primary practice location

2002 Medical Pkwy Ste 500
Annapolis, MD 21401-3268

Mailing address

2002 Medical Pkwy Ste 500
Annapolis, MD 21401-3268
Phone (410) 573-6480

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20260125000073 MD Practitioner - Nurse Practitioner 0244717874 Reassigns benefits to 1 organization
I20260125000092 DC Practitioner - Nurse Practitioner 0244717874 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medstar Medical Group II LLCGroup PAC ID 0547413825, 3,726 clinicians

Practice addresses (Care Compare)

1630 Main St
Chester, MD 21619-2791
Phone (410) 643-3186

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R169473MDMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Medstar Medical Group II LLC CurrentSince Jan 1, 2026 Accepting new patients
Medstar Medical Group II LLC CurrentSince Jan 1, 2026 Accepting new patients

Locations

1145 19th St NW
Ste 311
Washington, DC 20036
Phone (202) 429-2401

2002 Medical Pkwy
Ste 500
Annapolis, MD 21401
Phone (410) 573-6480

2002 Medical Pkwy
Annapolis, MD 21401
Phone (443) 481-4915

1630 Main St
Chester, MD 21619
Phone (410) 604-2555

Organizations & group practices 2

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

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1765411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765411200000",
    "number": "1386508638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2002 MEDICAL PKWY STE 500",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214013268",
            "telephone_number": "410-573-6480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2002 MEDICAL PKWY STE 500",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214013268",
            "telephone_number": "410-573-6480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUMPHREYS",
        "first_name": "NICOLE",
        "middle_name": "C",
        "name_prefix": "Mrs.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-12-11",
        "last_updated": "2025-12-11",
        "certification_date": "2025-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MD",
            "license": "R169473",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Annapolis, MD

Sources for this page

Verify at the official NPI Registry.