Individual provider Active NPI

Brittany Elizabeth Dickert, FNP

  • Family Nurse Practitioner
  • Annapolis, MD
National Provider Identifier
1598165474
Registry record updated Oct 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R191163 Issued in MD
Practice address
621 Ridgely Ave Ste 201
Annapolis, MD 21401-1083
Phone
(410) 224-4887
Fax
(410) 224-1428
NPI assigned
Aug 28, 2014
Last updated
Oct 13, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R191163 MD Primary

Addresses

Primary practice location

621 Ridgely Ave Ste 201
Annapolis, MD 21401-1083

Mailing address

621 Ridgely Ave Ste 201
Annapolis, MD 21401-1083
Phone (410) 224-4887

Other identifiers 1

IdentifierTypeStateIssuer
119060100MedicaidMD

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
I20170417000290 MD Practitioner - Nurse Practitioner 5991081515 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Kinetic Primary CareGroup PAC ID 5294192779, 9 clinicians
Chesapeake Digestive Associates, PCGroup PAC ID 5597151357, 38 clinicians

Practice addresses (Care Compare)

30 N PL
Frederick, MD 21701-6200
Phone (804) 742-2613

621 Ridgely Ave
Suite 201
Annapolis, MD 21401-1083
Phone 4102244887421

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R191163MDMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Chesapeake Digestive Associates, PC CurrentSince May 1, 2022 Accepting new patients

Locations

621 Ridgely Ave
Ste 201
Annapolis, MD 21401
Phone (410) 224-4887

Organizations & group practices 2

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1409184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602547200000",
    "number": "1598165474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "621 RIDGELY AVE STE 201",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214011083",
            "telephone_number": "410-224-4887",
            "fax_number": "410-224-1428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 RIDGELY AVE STE 201",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214011083",
            "telephone_number": "410-224-4887",
            "fax_number": "410-224-1428"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICKERT",
        "first_name": "BRITTANY",
        "middle_name": "ELIZABETH",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-28",
        "last_updated": "2020-10-13",
        "certification_date": "2020-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R191163",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "119060100",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Annapolis, MD

Sources for this page

Verify at the official NPI Registry.