Individual provider Active NPI

Caroline Moughon Wettengel, CRNP

  • Family Nurse Practitioner
  • Columbia, MD
National Provider Identifier
1447746144
Registry record updated Aug 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R220003 Issued in MD
Practice address
9891 Broken Land Pkwy Ste 100
Columbia, MD 21046-1156
Phone
(410) 730-6000
NPI assigned
Jul 5, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2025

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 R220003 MD Primary

Addresses

Primary practice location

9891 Broken Land Pkwy Ste 100
Columbia, MD 21046-1156

Mailing address

9891 Broken Land Pkwy Ste 100
Columbia, MD 21046-1156
Phone (410) 730-6000

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
I20180914002592 MD Practitioner - Nurse Practitioner 0345591269 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Allergy and Asthma Center of Central Maryland, PAGroup PAC ID 1557274255, 4 clinicians

Practice addresses (Care Compare)

9891 Broken Land Pkwy
Suite 100
Columbia, MD 21046-1156
Phone (410) 730-6000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R220003MDMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Johns Hopkins Community Physicians, Inc CurrentSince Apr 1, 2020 Accepting new patients
Johns Hopkins Community Physicians CurrentSince Apr 1, 2020 Accepting new patients
Johns Hopkins Community Physicians, Inc Current Accepting new patients
Allergy & Asthma Center of Central Maryland, PA CurrentSince Aug 13, 2021 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

1000 E Eager St
Baltimore, MD 21202
Phone (410) 522-9800

9891 Broken Land Pkwy
Ste 100
Columbia, MD 21046
Phone (410) 730-6000

Interoperability endpoints

  • Direct secure messaging: caroline.moughon.1@10561.direct.athenahealth.com

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1530748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755648000000",
    "number": "1447746144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9891 BROKEN LAND PKWY STE 100",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210461156",
            "telephone_number": "410-730-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9891 BROKEN LAND PKWY STE 100",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210461156",
            "telephone_number": "410-730-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WETTENGEL",
        "first_name": "CAROLINE",
        "middle_name": "MOUGHON",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-05",
        "last_updated": "2025-08-20",
        "certification_date": "2025-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R220003",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MD

Sources for this page

Verify at the official NPI Registry.