Active NPI
Chelsea Mongan, CRNP
- Pediatric Nurse Practitioner
- Baltimore, MD
National Provider Identifier
1447894506
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- TPAC1002
- Practice address
- 22 S Greene St
Baltimore, MD 21201-1544 - Phone
- (410) 328-7373
- Fax
- (410) 328-7305
- NPI assigned
- Nov 1, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | SP021047 | PA | |
| Pediatric Nurse Practitioner | 363LP0200X | TPAC1002 | MD | Primary |
Addresses
Primary practice location
22 S Greene St
Baltimore, MD 21201-1544
Mailing address
PO Box 62063
Baltimore, MD 21264-2063
Phone (410) 706-5181
Other practice location 1
2546 Knights Rd
Bensalem, PA 19020-3407
Phone (215) 245-8873
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)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| TPAC1002 | MD | MD | Pediatric Nurse Practitioner |
| SP021047 | PA | MD | Pediatric Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Frederick Health Hospital Inc | Past | Accepting new patients |
Interoperability endpoints
- cmongan40160@direct.kennedykrieger.org
Organizations & group practices 1
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.
-
- General Acute Care Hospital
- Frederick, MD
- NPI 1538165527
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1572566400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1642550400000",
"number": "1447894506",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 62063",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212642063",
"telephone_number": "410-706-5181",
"fax_number": "410-706-5103"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "22 S GREENE ST",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212011544",
"telephone_number": "410-328-7373",
"fax_number": "410-328-7305"
}
],
"practiceLocations": [
{
"address_1": "2546 Knights Rd",
"address_purpose": "LOCATION",
"city": "Bensalem",
"state": "PA",
"postal_code": "190203407",
"country_code": "US",
"telephone_number": "215-245-8873",
"fax_number": "215-245-8895",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MONGAN",
"first_name": "CHELSEA",
"credential": "CRNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-11-01",
"last_updated": "2022-01-19",
"certification_date": "2022-01-19",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "PA",
"license": "SP021047",
"primary": false
},
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "MD",
"license": "TPAC1002",
"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 Jan 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.