Individual provider Active NPI

Mary Jo Holloran, CRNP

  • Nurse Practitioner
  • Towson, MD
National Provider Identifier
1558375600
Registry record updated Nov 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
R072884 Issued in MD
Practice address
8322 Bellona Ave
Suite 100
Towson, MD 21204-2065
Phone
(410) 337-7900
Fax
(410) 821-1334
NPI assigned
Jul 27, 2006
Last updated
Nov 13, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X R072884 MD Primary

Addresses

Primary practice location

8322 Bellona Ave
Suite 100
Towson, MD 21204-2065

Mailing address

8322 Bellona Ave
Suite 100
Towson, MD 21204-2065
Phone (410) 337-7900

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
I20100309000549 MD Practitioner - Nurse Practitioner 2860537271 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Agape Physical Therapy and Sports Rehabilitation LPGroup PAC ID 3870741390, 684 clinicians

Practice addresses (Care Compare)

12 Newport Dr
Suite a
Forest Hill, MD 21050-1758

8322 Bellona Ave
Towson, MD 21204-2065

9110 Philadelphia Rd
Suite 308
Rosedale, MD 21237-4327
Phone (410) 569-8587

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of Maryland St. Joseph Orthopaedics, LLC CurrentSince Feb 1, 2013 Accepting new patients
University of Maryland St. Joseph Orthopaedics, LLC CurrentSince Feb 1, 2013 Accepting new patients
Orthopaedic Associates, PA Past Accepting new patients
Orthopaedic Associates, PA Past Accepting new patients

Locations

9110 Philadelphia Rd
Ste 308
Rosedale, MD 21237
Phone (410) 337-7900

8322 Bellona Ave
Towson, MD 21204
Phone (410) 328-3645

8322 Bellona Ave
Rm 100
Towson, MD 21204
Phone (410) 337-7900

Interoperability endpoints

  • Direct secure messaging: maryjoholloran@towsonorth.allscriptsdirect.net
  • Direct secure messaging: mholloran123435@direct.umm.edu

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1384300800000",
    "number": "1558375600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8322 BELLONA AVE",
            "address_2": "SUITE 100",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212042065",
            "telephone_number": "410-337-7900",
            "fax_number": "410-821-1334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8322 BELLONA AVE",
            "address_2": "SUITE 100",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212042065",
            "telephone_number": "410-337-7900",
            "fax_number": "410-821-1334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLORAN",
        "first_name": "MARY JO",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-27",
        "last_updated": "2013-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MD",
            "license": "R072884",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Towson, MD

Sources for this page

Verify at the official NPI Registry.