Individual provider Active NPI

Nicole B. F. Mullendore, FNP-BC

  • Family Nurse Practitioner
  • Frederick, MD
National Provider Identifier
1437409489
Registry record updated Jul 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R162044 Issued in MD
Practice address
501 W 7TH St
Frederick, MD 21701
Phone
(301) 698-8374
Fax
(240) 439-8910
NPI assigned
Sep 18, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 30, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R162044 MD Primary

Addresses

Primary practice location

501 W 7TH St
Frederick, MD 21701

Mailing address

PO Box 37086
Baltimore, MD 21297-3086
Phone (240) 439-8913

Other practice location 1

11116 Medical Campus Rd
Hagerstown, MD 21742-6710
Phone (301) 790-8000

Other practice location 2

11116 Medical Campus Rd
Hagerstown, MD 21742-6710
Phone (301) 790-8000

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
I20140522001821 MD Practitioner - Nurse Practitioner 2668695404 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

501 W 7TH St
Frederick, MD 21701-4586
Phone (301) 360-2574

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.07 of 100Reported as group
Quality
75.5
Promoting interoperability
100
Improvement activities
40
Cost
68.06

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R162044MDMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Frederick Health Medical Group LLC Current Accepting new patients
Frederick Health Medical Group LLC CurrentSince Jul 1, 2018 Accepting new patients
Frederick Health Medical Group LLC CurrentSince Jul 1, 2018 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

400 W 7th St
Frederick, MD 21701
Phone (240) 566-3300

501 W 7th St
Frederick, MD 21701
Phone (301) 360-2574

Organizations & group practices 4

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 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": "1347926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564444800000",
    "number": "1437409489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 37086",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212973086",
            "telephone_number": "240-439-8913",
            "fax_number": "240-439-8910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 W 7TH ST",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "21701",
            "telephone_number": "301-698-8374",
            "fax_number": "240-439-8910"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11116 Medical Campus Rd",
            "address_purpose": "LOCATION",
            "city": "Hagerstown",
            "state": "MD",
            "postal_code": "217426710",
            "country_code": "US",
            "telephone_number": "301-790-8000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11116 Medical Campus Rd",
            "address_purpose": "LOCATION",
            "city": "Hagerstown",
            "state": "MD",
            "postal_code": "217426710",
            "country_code": "US",
            "telephone_number": "301-790-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MULLENDORE",
        "first_name": "NICOLE",
        "middle_name": "B. F.",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-09-18",
        "last_updated": "2019-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R162044",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Frederick, MD

Sources for this page

Verify at the official NPI Registry.