Individual provider Active NPI

Mary Elizabeth O'Brien, CRNP

  • Primary Care Nurse Practitioner
  • Laurel, MD
National Provider Identifier
1578554887
Registry record updated Jul 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
R073974 Issued in MD
Practice address
13952 Baltimore Ave
Laurel, MD 20707-5000
Phone
(301) 490-1990
Fax
(301) 490-8750
NPI assigned
Nov 4, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X R073974 MD Primary

Addresses

Primary practice location

13952 Baltimore Ave
Laurel, MD 20707-5000

Mailing address

13952 Baltimore Ave
Laurel, MD 20707-5000
Phone (301) 490-1990

Other identifiers 1

IdentifierTypeStateIssuer
333703100MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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
I20050126001002 DC Practitioner - Nurse Practitioner 7416907522 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R073974MDMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group, LLC CurrentSince Apr 30, 2017 Accepting new patients
Privia Care Center LLC CurrentSince Oct 4, 2018 Accepting new patients
Privia Care Center LLC CurrentSince Oct 4, 2018 Accepting new patients
Privia Medical Group, LLC CurrentSince Apr 30, 2017 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

4910 Massachusetts Ave NW
Ste 114
Washington, DC 20016
Phone (202) 244-0812

9470 Annapolis Rd
Ste 309
Lanham, MD 20706
Phone (202) 832-1800

13952 Baltimore Ave
Laurel, MD 20707
Phone (301) 490-1990

950 N Glebe Rd
Ste 4000
Arlington, VA 22203
Phone (301) 593-9011

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1131062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1373068800000",
    "number": "1578554887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13952 BALTIMORE AVE",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207075000",
            "telephone_number": "301-490-1990",
            "fax_number": "301-490-8750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13952 BALTIMORE AVE",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207075000",
            "telephone_number": "301-490-1990",
            "fax_number": "301-490-8750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'BRIEN",
        "first_name": "MARY",
        "middle_name": "ELIZABETH",
        "name_prefix": "Mrs.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-04",
        "last_updated": "2013-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MD",
            "license": "R073974",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "333703100",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Laurel, MD

Sources for this page

Verify at the official NPI Registry.