Mary Kathleen Haber, CRNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R195767 Issued in MD

Practice address

1040 Park Ave Ste 200
Baltimore, MD 21201-5634

Phone

(443) 738-0300

Fax

(443) 738-0301

NPI assigned

Nov 5, 2015

Last updated

Jun 16, 2018By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other names 1

• Mary Kathleen Lynch Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Charm City Wellness Collaborative, LLC

  • Family Nurse Practitioner
  • Baltimore, MD
  • NPI 1649046814

  Lactation Consultant

  NPD
• Lifebridge Community Physicians, Inc

  • Cardiovascular Disease Physician
  • Timonium, MD
  • NPI 1174815807
  NPD
• Frederick Health Hospital Inc

  dba Frederick Health Hospital

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)
• Lifebridge Community Physicians Inc

  • Internal Medicine Physician
  • Randallstown, MD
  • NPI 1447983325
  NPD (past)
• Sinai Hospital of Baltimore Inc

  • Obstetrics & Gynecology Physician
  • Randallstown, MD
  • NPI 1386481943
  NPD (past)

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

{
    "created_epoch": "1446681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529107200000",
    "number": "1528431020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2140 PEACHTREE RD NW STE 232",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303091316",
            "telephone_number": "404-231-4431",
            "fax_number": "404-231-5677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 PARK AVE STE 200",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212015634",
            "telephone_number": "443-738-0300",
            "fax_number": "443-738-0301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HABER",
        "first_name": "MARY",
        "middle_name": "KATHLEEN",
        "name_prefix": "Mrs.",
        "credential": "CRNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-11-05",
        "last_updated": "2018-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R195767",
            "primary": true
        },
        {
            "code": "163WL0100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Lactation Consultant",
            "state": "MD",
            "license": "R195767",
            "primary": false
        },
        {
            "code": "163WL0100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Lactation Consultant",
            "state": "MD",
            "license": "L-46806",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "LYNCH",
            "middle_name": "KATHLEEN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Daniel Jennings Haase, MD
• Lindsay Haasis, LCPC
• Nader Habashi, M.D.
• Hania Habeeb, M.D.
• Eric Haber, LCSW-C
• Naomi Alexandra Haber, LCSW-C
• Sarah Anne Haberbosch, LCSW-C
• Catherine A Haberman, LCSWC
• Sergio Haberman
• Patrick Habermas, LMSW

• Family Nurse Practitioner in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Family Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.