Individual provider Active NPI

Beverly Thomas, RN

  • Registered Nurse
  • Baltimore, MD
National Provider Identifier
1629467329
Registry record updated Jan 19, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RN1004211 Issued in DC
Practice address
9601 Pulaski Park Dr
Suite 417
Baltimore, MD 21220-1409
Phone
(443) 725-2665
NPI assigned
Jan 19, 2015
Last updated
Jan 19, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN1004211 DC Primary
Registered Nurse 163W00000X R114017 MD

Addresses

Primary practice location

9601 Pulaski Park Dr
Suite 417
Baltimore, MD 21220-1409

Mailing address

9601 Pulaski Park Dr
Suite 417
Baltimore, MD 21220-1409
Phone (443) 725-2665

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN1004211DCMDRegistered Nurse
R114017MDMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1421625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421625600000",
    "number": "1629467329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9601 PULASKI PARK DR",
            "address_2": "SUITE 417",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212201409",
            "telephone_number": "443-725-2665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9601 PULASKI PARK DR",
            "address_2": "SUITE 417",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212201409",
            "telephone_number": "443-725-2665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "BEVERLY",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-19",
        "last_updated": "2015-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "DC",
            "license": "RN1004211",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MD",
            "license": "R114017",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.