Individual provider Active NPI

Katherine Houglum, CRNP

  • Pediatric Nurse Practitioner
  • Baltimore, MD
National Provider Identifier
1417356486
Registry record updated Aug 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
R177864 Issued in MD
Practice address
200 E 33Rd St
Suite 233
Baltimore, MD 21218-3322
Phone
(410) 554-2696
NPI assigned
Aug 15, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X R177864 MD Primary

Addresses

Primary practice location

200 E 33Rd St
Suite 233
Baltimore, MD 21218-3322

Mailing address

6501 Copper Ridge Dr Apt T1
Baltimore, MD 21209-2349
Phone (301) 980-2192

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
R177864MDMDPediatric Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1408060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408060800000",
    "number": "1417356486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6501 COPPER RIDGE DR APT T1",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212092349",
            "telephone_number": "301-980-2192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 E 33RD ST",
            "address_2": "SUITE 233",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212183322",
            "telephone_number": "410-554-2696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOUGLUM",
        "first_name": "KATHERINE",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-15",
        "last_updated": "2014-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MD",
            "license": "R177864",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Aug 15, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.