Individual provider Active NPI

Kellie Nicole Burroughs, APRN

  • Nurse Practitioner
  • Baltimore, MD
National Provider Identifier
1396366613
Registry record updated Aug 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AP145721 Issued in TX
Practice address
5601 Loch Raven Blvd
Baltimore, MD 21239-2950
Phone
(443) 444-4561
NPI assigned
Apr 27, 2020
Last updated
Aug 14, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 14, 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 AP145721 TX Primary

Addresses

Primary practice location

5601 Loch Raven Blvd
Baltimore, MD 21239-2950

Mailing address

420 W Slaughter LN Apt 1033
Austin, TX 78748-1756
Phone (410) 829-8804

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
I20220321000035 MD Practitioner - Nurse Practitioner 5294120788 Reassigns benefits to 2 organizations
I20220321000109 DC Practitioner - Nurse Practitioner 5294120788 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Drexel University College of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Medstar Medical Group II LLCGroup PAC ID 0547413825, 3,726 clinicians
Medstar Health Weight Management, LLCGroup PAC ID 0840634267, 103 clinicians

Practice addresses (Care Compare)

5601 Lloch Raven Blvd
Baltimore, MD 21239-2945
Phone (443) 444-8000

821 W Benfield Rd
Suite 6
Severna Park, MD 21146-2220
Phone (410) 975-5447

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.34 of 100Reported as group
Quality
67.9
Promoting interoperability
100
Improvement activities
40
Cost
69.47

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP145721TXMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Medstar Health Weight Management, LLC Single Specialty CurrentSince Oct 25, 2025 Accepting new patients
Medstar Medical Group II LLC Single Specialty CurrentSince Feb 1, 2022 Accepting new patients
Medstar Medical Group II LLC CurrentSince Feb 1, 2022 Accepting new patients

Locations

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

5601 Loch Raven Blvd
Baltimore, MD 21239
Phone (443) 444-4714

29955 Three Notch Rd
Ste 100
Charlotte Hall, MD 20622
Phone (301) 290-5300

499 Idlewild Ave
Ste 104
Easton, MD 21601
Phone (410) 697-3832

25500 Point Lookout Rd
Leonardtown, MD 20650
Phone (301) 475-6106

1099 Winterson Rd
Ste 300
Linthicum Heights, MD 21090
Phone (443) 929-1785

18101 Prince Philip Dr
Olney, MD 20832
Phone (301) 774-8618

821 W Benfield Rd
Ste 6
Severna Park, MD 21146
Phone (410) 975-5447

Interoperability endpoints

  • Direct secure messaging: burroughs.kelli@ca-md.direct.office.nextgen.com
  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 3

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.

Hospital & facility affiliations 1

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": "1587945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755129600000",
    "number": "1396366613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 W SLAUGHTER LN APT 1033",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787481756",
            "telephone_number": "410-829-8804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5601 LOCH RAVEN BLVD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212392950",
            "telephone_number": "443-444-4561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURROUGHS",
        "first_name": "KELLIE",
        "middle_name": "NICOLE",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-04-27",
        "last_updated": "2025-08-14",
        "certification_date": "2025-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "AP145721",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.