Individual provider Active NPI

Brenda Davis, CRNP

  • Family Nurse Practitioner
  • Bethesda, MD
National Provider Identifier
1588065833
Registry record updated Apr 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R151553 Issued in MD
Practice address
4954 N Palmer Rd
America Building 19, 3Rd Floor, Hematology Oncology
Bethesda, MD 20889-5630
Phone
(301) 319-2367
NPI assigned
Sep 5, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2024

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 R151553 MD
Family Nurse Practitioner 363LF0000X R151553 MD Primary

Addresses

Primary practice location

4954 N Palmer Rd
America Building 19, 3Rd Floor, Hematology Oncology
Bethesda, MD 20889-5630

Mailing address

4954 N Palmer Rd
America Building 19, 3Rd Floor, Hematology Oncology
Bethesda, MD 20889-5630
Phone (301) 319-2367

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
I20150227001067 MD Order and Referring Only - Nurse Practitioner 7416273925

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R151553MDMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Frederick Health Hospital Inc Past Accepting new patients

Organizations & group practices 1

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": "1409875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711929600000",
    "number": "1588065833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4954 N PALMER RD",
            "address_2": "AMERICA BUILDING 19, 3RD FLOOR, HEMATOLOGY ONCOLOGY",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208895630",
            "telephone_number": "301-319-2367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4954 N PALMER RD",
            "address_2": "AMERICA BUILDING 19, 3RD FLOOR, HEMATOLOGY ONCOLOGY",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208895630",
            "telephone_number": "301-319-2367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "BRENDA",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-05",
        "last_updated": "2024-04-01",
        "certification_date": "2024-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MD",
            "license": "R151553",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R151553",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethesda, MD

Sources for this page

Verify at the official NPI Registry.