Individual provider Active NPI

June Sunyung Gupta, NURSE PRACTITIONER

  • Women's Health Nurse Practitioner
  • Baltimore, MD
National Provider Identifier
1639160518
Registry record updated Oct 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
R170167 Issued in MD
Practice address
330 N Howard St
Baltimore, MD 21201-3610
Phone
(410) 576-1414
NPI assigned
Oct 31, 2005
Last updated
Oct 14, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X 201392011NP-PP OR
Women's Health Nurse Practitioner 363LW0102X R170167 MD Primary

Addresses

Primary practice location

330 N Howard St
Baltimore, MD 21201-3610

Mailing address

1225 4TH St NE
Washington, DC 20002-3431
Phone (202) 347-8512

Other practice location 1

5001 Silver Hill Rd Ste 103
Suitland, MD 20746-5208
Phone (301) 241-0510

Other practice location 2

19650 Club House Rd Ste 104
Montgomery Village, MD 20886-3039
Phone (301) 208-1300

Other identifiers 3

IdentifierTypeStateIssuer
2034969MedicaidWA
547715800MedicaidMD
500666326MedicaidOR

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
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R170167MDMDWomen's Health Nurse Practitioner
201392011NP-PPORMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Planned Parenthood of Maryland, Inc. Past Accepting new patients
Planned Parenthood of Metropolitan Washington DC Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Planned Parenthood of Metropolitan Washington DC Past Accepting new patients

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1130716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665705600000",
    "number": "1639160518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1225 4TH ST NE",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200023431",
            "telephone_number": "202-347-8512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 N HOWARD ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212013610",
            "telephone_number": "410-576-1414"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5001 Silver Hill Rd Ste 103",
            "address_purpose": "LOCATION",
            "city": "Suitland",
            "state": "MD",
            "postal_code": "207465208",
            "country_code": "US",
            "telephone_number": "301-241-0510",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "19650 Club House Rd Ste 104",
            "address_purpose": "LOCATION",
            "city": "Montgomery Village",
            "state": "MD",
            "postal_code": "208863039",
            "country_code": "US",
            "telephone_number": "301-208-1300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUPTA",
        "first_name": "JUNE",
        "middle_name": "SUNYUNG",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-31",
        "last_updated": "2022-10-14",
        "certification_date": "2022-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "OR",
            "license": "201392011NP-PP",
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "MD",
            "license": "R170167",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2034969",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "547715800",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500666326",
            "state": "OR"
        }
    ],
    "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 Oct 14, 2022; 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.