Individual provider Active NPI

Abby Davis, CRNP

  • Family Nurse Practitioner
  • Pasadena, MD
National Provider Identifier
1457873044
Registry record updated Aug 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R212705 Issued in MD
Practice address
24 Magothy Beach Rd Ste a
Pasadena, MD 21122-4414
Phone
(410) 255-2700
Fax
(410) 437-1962
NPI assigned
Jul 14, 2017
Last updated
Aug 11, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 11, 2020

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 R212705 MD Primary

Addresses

Primary practice location

24 Magothy Beach Rd Ste a
Pasadena, MD 21122-4414

Mailing address

7580 Buckingham Blvd Ste 220
Hanover, MD 21076-3210
Phone (410) 729-5100

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
I20171006001496 MD Practitioner - Nurse Practitioner 1355616913 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R212705MDMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Maryland Primary Care Physicians, LLC CurrentSince Aug 14, 2017 Accepting new patients
Johns Hopkins Community Physicians CurrentSince Apr 1, 2020 Accepting new patients
Johns Hopkins Community Physicians, Inc Current Accepting new patients
Johns Hopkins Community Physicians, Inc CurrentSince Apr 1, 2020 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

1509 Ritchie Hwy
Arnold, MD 21012
Phone (410) 757-1600

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

7580 Buckingham Blvd
Ste 220
Hanover, MD 21076
Phone (410) 729-5100

1111 Benfield Blvd
Ste 200
Millersville, MD 21108
Phone (410) 729-5100

24 Magothy Beach Rd
Ste A
Pasadena, MD 21122
Phone (410) 255-2700

Interoperability endpoints

  • Direct secure messaging: abby.davis.1@10921.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1499990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597104000000",
    "number": "1457873044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7580 BUCKINGHAM BLVD STE 220",
            "city": "HANOVER",
            "state": "MD",
            "postal_code": "210763210",
            "telephone_number": "410-729-5100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 MAGOTHY BEACH RD STE A",
            "city": "PASADENA",
            "state": "MD",
            "postal_code": "211224414",
            "telephone_number": "410-255-2700",
            "fax_number": "410-437-1962"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "ABBY",
        "name_prefix": "Ms.",
        "credential": "CRNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-07-14",
        "last_updated": "2020-08-11",
        "certification_date": "2020-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R212705",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, MD

Sources for this page

Verify at the official NPI Registry.