Individual provider Active NPI

Judy Lyn Hetherington, CRNP

  • Nurse Practitioner
  • Baltimore, MD
National Provider Identifier
1538102603
Registry record updated Aug 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
R131559 Issued in MD
Practice address
600 N Wolfe St
Baltimore, MD 21287-0005
Phone
(443) 997-0400
NPI assigned
Jun 14, 2006
Last updated
Aug 12, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X R131559 MD Primary
Medical Oncology Physician 207RX0202X R131559 MD

Addresses

Primary practice location

600 N Wolfe St
Baltimore, MD 21287-0005

Mailing address

6201 Greenleigh Ave
Middle River, MD 21220-2004

Other practice location 1

10753 Falls Road Pavilion II
Baltimore, MD 21093
Phone (410) 847-3800

Other identifiers 3

IdentifierTypeStateIssuer
699815100MedicaidMD
C31152OtherMDR/R MEDICARE GROUP #
P00123941OtherMDR/R MEDICARE PROVIDER #

Other names 1

  • Ms. Judy Lyn Weninger Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20100925000011 MD Practitioner - Nurse Practitioner 0941326185 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2000
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Johns Hopkins UniversityGroup PAC ID 8921903147, 2,886 clinicians

Practice addresses (Care Compare)

600 N Wolf St
Baltimore, MD 21287-0005
Phone (410) 955-5000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.31 of 100Reported as group
Quality
73.89
Promoting interoperability
100
Improvement activities
40
Cost
70.47

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R131559MDMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Johns Hopkins University CurrentSince Nov 1, 2010 Accepting new patients
Johns Hopkins University Medical Oncology CurrentSince Nov 1, 2010 Accepting new patients
Johns Hopkins University Current Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

2401 W Belvedere Ave
Baltimore, MD 21215

600 N Wolfe St
Baltimore, MD 21287

5755 Cedar Ln
Columbia, MD 21044
Phone (410) 381-7171

10753 Falls Rd
Lutherville Timonium, MD 21093
Phone (410) 583-2665

6201 Greenleigh Ave
Middle River, MD 21220
Phone (410) 933-2704

Interoperability endpoints

  • Direct secure messaging: jhetherington34363@direct.hopkinsmedicine.org

Organizations & group practices 4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660262400000",
    "number": "1538102603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6201 GREENLEIGH AVE",
            "city": "MIDDLE RIVER",
            "state": "MD",
            "postal_code": "212202004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 N WOLFE ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212870005",
            "telephone_number": "443-997-0400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10753 Falls Road Pavilion II",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "21093",
            "country_code": "US",
            "telephone_number": "410-847-3800",
            "fax_number": "410-847-3805",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HETHERINGTON",
        "first_name": "JUDY",
        "middle_name": "LYN",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-14",
        "last_updated": "2022-08-12",
        "certification_date": "2022-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MD",
            "license": "R131559",
            "primary": true
        },
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "MD",
            "license": "R131559",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "699815100",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "R/R MEDICARE GROUP #",
            "identifier": "C31152",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "R/R MEDICARE PROVIDER #",
            "identifier": "P00123941",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JUDY",
            "last_name": "WENINGER",
            "middle_name": "LYN",
            "prefix": "MS.",
            "credential": "CRNP",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.