Individual provider Active NPI

Melanie Short Letzer, CRNP

  • Gerontology Nurse Practitioner
  • Elkridge, MD
National Provider Identifier
1639229370
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
R133532 Issued in MD
Practice address
6085 Marshalee Dr
Suite 110
Elkridge, MD 21075-6023
Phone
(443) 506-4370
NPI assigned
Jan 12, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X R133532 MD Primary

Addresses

Primary practice location

6085 Marshalee Dr
Suite 110
Elkridge, MD 21075-6023

Mailing address

4513 Rusty Gate
Ellicott City, MD 21043-6566
Phone (410) 461-9131

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
I20120806000258 MD Practitioner - Nurse Practitioner 8123274214 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R133532MDMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Frederick Health Hospital Inc Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1168560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1639229370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4513 RUSTY GATE",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210436566",
            "telephone_number": "410-461-9131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6085 MARSHALEE DR",
            "address_2": "SUITE 110",
            "city": "ELKRIDGE",
            "state": "MD",
            "postal_code": "210756023",
            "telephone_number": "443-506-4370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LETZER",
        "first_name": "MELANIE",
        "middle_name": "SHORT",
        "name_prefix": "Mrs.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MD",
            "license": "R133532",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elkridge, MD

Sources for this page

Verify at the official NPI Registry.