Active NPI
Jeanette R McDaniel, MD
- Pediatrics Physician
- Baltimore, MD
National Provider Identifier
1528035607
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- D0034935
- Practice address
- 1829 Reisterstown Road
Suite 205
Baltimore, MD 21208 - Phone
- (410) 602-9850
- Fax
- (410) 602-9857
- NPI assigned
- Mar 7, 2006
- 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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | D0034935 | MD | Primary |
Addresses
Primary practice location
1829 Reisterstown Road
Suite 205
Baltimore, MD 21208
Mailing address
1829 Reisterstown Road
Suite 205
Baltimore, MD 21208
Phone (410) 602-9850
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 48402160 | Medicaid | MD |
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
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D0034935 | MD | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Randall Emergency Physicians LLC | Past | Accepting new patients | |
| Lifebridge Community Physicians, Inc | Past | Accepting new patients |
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.
-
- Cardiovascular Disease Physician
- Timonium, MD
- NPI 1174815807
-
- Emergency Medicine Physician
- Randallstown, MD
- NPI 1679526347
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1141689600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1346889600000",
"number": "1528035607",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1829 REISTERSTOWN ROAD",
"address_2": "SUITE 205",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "21208",
"telephone_number": "410-602-9850",
"fax_number": "410-602-9857"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1829 REISTERSTOWN ROAD",
"address_2": "SUITE 205",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "21208",
"telephone_number": "410-602-9850",
"fax_number": "410-602-9857"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCDANIEL",
"first_name": "JEANETTE",
"middle_name": "R",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-03-07",
"last_updated": "2012-09-06",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MD",
"license": "D0034935",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "48402160",
"state": "MD"
}
],
"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 Sep 6, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.