Individual provider Active NPI

Maribeth Hess Tan, RRA

  • Radiology Practitioner Assistant
  • Westminster, MD
National Provider Identifier
1629897335
Registry record updated Oct 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiology Practitioner AssistantTaxonomy code 243U00000X
License
K00009 Issued in MD
Practice address
200 Memorial Ave
Westminster, MD 21157-5726
Phone
(410) 871-6884
NPI assigned
Oct 9, 2024
Last updated
Oct 9, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiology Practitioner Assistant 243U00000X K00009 MD Primary

Addresses

Primary practice location

200 Memorial Ave
Westminster, MD 21157-5726

Mailing address

200 Memorial Ave
Westminster, MD 21157-5726
Phone (410) 871-6884

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

State licenses

LicenseStateTypeSpecialty
K00009MDMDRadiology Practitioner Assistant

NPI Registry JSON

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

{
    "created_epoch": "1728432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728432000000",
    "number": "1629897335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 MEMORIAL AVE",
            "city": "WESTMINSTER",
            "state": "MD",
            "postal_code": "211575726",
            "telephone_number": "410-871-6884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 MEMORIAL AVE",
            "city": "WESTMINSTER",
            "state": "MD",
            "postal_code": "211575726",
            "telephone_number": "410-871-6884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAN",
        "first_name": "MARIBETH",
        "middle_name": "HESS",
        "credential": "RRA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-09",
        "last_updated": "2024-10-09",
        "certification_date": "2024-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "243U00000X",
            "taxonomy_group": "",
            "desc": "Radiology Practitioner Assistant",
            "state": "MD",
            "license": "K00009",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westminster, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2024; 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.