Active NPI
Siara Pridgen
- Phlebology Physician
- Baltimore, MD
National Provider Identifier
1487588935
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Phlebology Physician
- License
- 25-CPT1500
- Practice address
- 4709 Harford Rd
Baltimore, MD 21214-3205 - Phone
- (410) 240-0404
- NPI assigned
- Jun 10, 2026
- 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 |
|---|---|---|---|---|
| Phlebology Physician | 202K00000X | 25-CPT1500 | MD | Primary |
Addresses
Primary practice location
4709 Harford Rd
Baltimore, MD 21214-3205
Mailing address
4709 Harford Rd # 86
Baltimore, MD 21214-3205
Phone (410) 240-0404
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)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1781049600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1781049600000",
"number": "1487588935",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4709 HARFORD RD # 86",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212143205",
"telephone_number": "410-240-0404"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4709 HARFORD RD",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212143205",
"telephone_number": "410-240-0404"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PRIDGEN",
"first_name": "SIARA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2026-06-10",
"last_updated": "2026-06-10",
"certification_date": "2026-06-10",
"status": "A"
},
"taxonomies": [
{
"code": "202K00000X",
"taxonomy_group": "",
"desc": "Phlebology",
"state": "MD",
"license": "25-CPT1500",
"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 Jun 10, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.