Active NPI
Sophia Pemberton, RN, CRNP
- Adult Health Nurse Practitioner
- Baltimore, MD
National Provider Identifier
1477913598
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Health Nurse Practitioner
- License
- R206505
- Practice address
- 1806 Thames St
Apt 11
Baltimore, MD 21231-3543 - Phone
- (614) 519-0359
- NPI assigned
- Mar 2, 2016
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | R206505 | MD | Primary |
Addresses
Primary practice location
1806 Thames St
Apt 11
Baltimore, MD 21231-3543
Mailing address
1806 Thames St
Apt 11
Baltimore, MD 21231-3543
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, Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R206505 | MD | MD | Adult Health Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1456876800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1456876800000",
"number": "1477913598",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1806 THAMES ST",
"address_2": "APT 11",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212313543"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1806 THAMES ST",
"address_2": "APT 11",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212313543",
"telephone_number": "614-519-0359"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEMBERTON",
"first_name": "SOPHIA",
"credential": "RN, CRNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-03-02",
"last_updated": "2016-03-02",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "MD",
"license": "R206505",
"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 Mar 2, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.