Individual provider Active NPI

Berthlyn M. Williams Scoulios, CRNP

  • Pediatric Nurse Practitioner
  • Takoma Park, MD
National Provider Identifier
1497080964
Registry record updated Sep 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
R138169 Issued in MD
Practice address
7676 New Hampshire Ave
Suite 220 a
Takoma Park, MD 20912-7512
Phone
(301) 431-2972
Fax
(301) 439-0008
NPI assigned
Oct 16, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X R138169 MD Primary

Addresses

Primary practice location

7676 New Hampshire Ave
Suite 220 a
Takoma Park, MD 20912-7512

Mailing address

7676 New Hampshire Ave
Suite 220 a
Takoma Park, MD 20912-7512
Phone (301) 431-2972

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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
I20161215001924 DC Practitioner - Nurse Practitioner 3072893767 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Community Clinic, Inc CurrentSince Nov 7, 2016 Accepting new patients
Community Clinic, Inc. CurrentSince Nov 7, 2016 Accepting new patients

Locations

220 Girard St
Ste 100
Gaithersburg, MD 20877
Phone (301) 216-0880

8665 Georgia Ave
Silver Spring, MD 20910
Phone (301) 340-7525

8630 Fenton St
Ste 1200
Silver Spring, MD 20910
Phone (301) 585-1250

8630 Fenton St
Ste 1204
Silver Spring, MD 20910
Phone (240) 499-2636

7676 New Hampshire Ave
Ste 220A
Takoma Park, MD 20912
Phone (301) 431-2972

Interoperability endpoints

  • Direct secure messaging: berthlyn.williamsscoulios.p1@direct.mcg-hhs.nextgenshare.com
  • Direct secure messaging: hscbscouli@yourcarecommunity.org

Organizations & group practices 2

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": "1255651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726444800000",
    "number": "1497080964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7676 NEW HAMPSHIRE AVE",
            "address_2": "SUITE 220 A",
            "city": "TAKOMA PARK",
            "state": "MD",
            "postal_code": "209127512",
            "telephone_number": "301-431-2972",
            "fax_number": "301-439-0008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7676 NEW HAMPSHIRE AVE",
            "address_2": "SUITE 220 A",
            "city": "TAKOMA PARK",
            "state": "MD",
            "postal_code": "209127512",
            "telephone_number": "301-431-2972",
            "fax_number": "301-439-0008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS SCOULIOS",
        "first_name": "BERTHLYN",
        "middle_name": "M.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-16",
        "last_updated": "2024-09-16",
        "certification_date": "2024-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MD",
            "license": "R138169",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Takoma Park, MD

Sources for this page

Verify at the official NPI Registry.