Individual provider Active NPI

Rebekah A Richardson, CRNP-ADULT

  • Adult Health Nurse Practitioner
  • Randallstown, MD
National Provider Identifier
1548568306
Registry record updated Apr 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
R187779 Issued in MD
Practice address
5401 Old Court Rd
Randallstown, MD 21133-5103
Phone
(410) 601-4486
Fax
(410) 601-9014
NPI assigned
Mar 3, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X R187779 MD Primary

Addresses

Primary practice location

5401 Old Court Rd
Randallstown, MD 21133-5103

Mailing address

5401 Old Court Rd
Randallstown, MD 21133-5103
Phone (410) 601-4486

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
I20110526000604 MD Practitioner - Nurse Practitioner 6103003215 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Sinai Hospital of Baltimore, IncGroup PAC ID 0941112346, 373 clinicians

Practice addresses (Care Compare)

5401 Old Court Rd
Randallstown, MD 21133-5103
Phone (410) 701-4545

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Sinai Hospital of Baltimore Inc CurrentSince Dec 14, 2015 Accepting new patients
Sinai Hospital of Baltimore Inc Current Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Sinai Hospital of Baltimore Inc Past Accepting new patients

Locations

2435 W Belvedere Ave
Ste 4
Baltimore, MD 21215
Phone (410) 601-5547

8875 Centre Park Dr
Ste D
Columbia, MD 21045
Phone (410) 489-3020

5401 Old Court Rd
Randallstown, MD 21133
Phone (301) 337-2727

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1299110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554768000000",
    "number": "1548568306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5401 OLD COURT RD",
            "city": "RANDALLSTOWN",
            "state": "MD",
            "postal_code": "211335103",
            "telephone_number": "410-601-4486",
            "fax_number": "410-601-9014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5401 OLD COURT RD",
            "city": "RANDALLSTOWN",
            "state": "MD",
            "postal_code": "211335103",
            "telephone_number": "410-601-4486",
            "fax_number": "410-601-9014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHARDSON",
        "first_name": "REBEKAH",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "CRNP-ADULT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-03",
        "last_updated": "2019-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MD",
            "license": "R187779",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Randallstown, MD

Sources for this page

Verify at the official NPI Registry.