Individual provider Active NPI

Jennifer L Wilhelm

  • Psychiatric/Mental Health Nurse Practitioner
  • Annapolis, MD
National Provider Identifier
1427320100
Registry record updated Jan 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
R212430 Issued in MD
Practice address
2635 Riva Rd
Annapolis, MD 21401-7430
Phone
(410) 573-9000
Fax
(410) 573-9001
NPI assigned
Jan 27, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X R212430 MD Primary

Addresses

Primary practice location

2635 Riva Rd
Annapolis, MD 21401-7430

Mailing address

2635 Riva Rd
Annapolis, MD 21401-7430
Phone (410) 573-9000

Other names 1

  • Jennifer Hanson Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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 1

Enrollment IDStateProvider typePAC IDDetails
I20141208001990 MD Practitioner - Nurse Practitioner 4183946866 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Luminis Health Medical Group, LLCGroup PAC ID 2860447315, 540 clinicians

Practice addresses (Care Compare)

175 Harry S Truman Pkwy
Annapolis, MD 21401-7573
Phone (410) 573-9000

2003 Medical Pkwy
Annapolis, MD 21401-3081

2003 Medical Pkwy Wayson Pavillion
Advanced Internal Medicine Residenc
Annapolis, MD 21401-3081
Phone (443) 951-4286

Hospital & facility affiliations

  • Luminis Health Anne Arundel Medical Center, Inc Hospital, Annapolis, MD, CCN 210023

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R212430MDMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Luminis Health Medical Group, LLC CurrentSince Oct 8, 2014 Accepting new patients
Luminis Health Medical Group, LLC CurrentSince Oct 8, 2014 Accepting new patients

Locations

2001 Medical Pkwy
Annapolis, MD 21401
Phone (410) 280-5601

2003 Medical Pkwy
Ste 301
Annapolis, MD 21401
Phone (443) 481-3366

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": "1327622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1420761600000",
    "number": "1427320100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2635 RIVA RD",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214017430",
            "telephone_number": "410-573-9000",
            "fax_number": "410-573-9001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2635 RIVA RD",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214017430",
            "telephone_number": "410-573-9000",
            "fax_number": "410-573-9001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILHELM",
        "first_name": "JENNIFER",
        "middle_name": "L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-27",
        "last_updated": "2015-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R212430",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "HANSON",
            "credential": "CRNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Annapolis, MD

Sources for this page

Verify at the official NPI Registry.