Individual provider Active NPI

Nicole Emily Bertram Love, M.D.

  • Ophthalmology Physician
  • Towson, MD
National Provider Identifier
1568416766
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
D0044675 Issued in MD
Practice address
8415 Bellona LN
Suite 212
Towson, MD 21204-2055
Phone
(410) 913-3740
NPI assigned
May 20, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X D0044675 MD Primary

Addresses

Primary practice location

8415 Bellona LN
Suite 212
Towson, MD 21204-2055

Mailing address

14770 Triadelphia Mill Rd
Dayton, MD 21036-1215
Phone (410) 913-3740

Other identifiers 1

IdentifierTypeStateIssuer
D0044675OtherMDSTATE MEDICAL LICENSE

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061020000239 MD Practitioner - Ophthalmology 5890791560 Practice locations: Annapolis, MD; Frederick, MD

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
University of Cincinnati College of Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

129 Lubrano Dr
Suite 101
Annapolis, MD 21401-7566
Phone (410) 913-3740

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
D0044675MDMDOphthalmology Physician

NPI Registry JSON

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

{
    "created_epoch": "1148083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1568416766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14770 TRIADELPHIA MILL RD",
            "city": "DAYTON",
            "state": "MD",
            "postal_code": "210361215",
            "telephone_number": "410-913-3740",
            "fax_number": "301-596-9271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8415 BELLONA LN",
            "address_2": "SUITE 212",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212042055",
            "telephone_number": "410-913-3740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERTRAM LOVE",
        "first_name": "NICOLE",
        "middle_name": "EMILY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MD",
            "license": "D0044675",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE MEDICAL LICENSE",
            "identifier": "D0044675",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Towson, MD

Sources for this page

Verify at the official NPI Registry.