Beth H Wieczorek, CRNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

R070205 Issued in MD

Practice address

707 N Broadway
Baltimore, MD 21205-1832

Phone

(443) 923-9200

Fax

(443) 923-9405

NPI assigned

Dec 19, 2006

Last updated

Nov 29, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: bwieczorek31107@direct.kennedykrieger.org
• Direct secure messaging: bwieczorek55525@direct.hopkinsmedicine.org

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.

• Kennedy Krieger Associates

  • Pediatrics Physician
  • Baltimore, MD
  • NPI 1871515783
  Medicare reassignment NPD
• Johns Hopkins University

  dba Jhu - Anesthesia Pain MGMT

  • Pain Medicine (Anesthesiology) Physician
  • Baltimore, MD
  • NPI 1922008549
  NPD
• Kennedy Krieger Associates

  • Pediatrics Physician
  • Middle River, MD
  • NPI 1841009842
  NPD
• Frederick Health Hospital Inc

  dba Frederick Health Hospital

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701216000000",
    "number": "1639232747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2931 E BIDDLE ST",
            "address_2": "PATIENT ACCOUNTING",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212133939",
            "telephone_number": "443-923-1886",
            "fax_number": "443-923-1895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 N BROADWAY",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212051832",
            "telephone_number": "443-923-9200",
            "fax_number": "443-923-9405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIECZOREK",
        "first_name": "BETH",
        "middle_name": "H",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-19",
        "last_updated": "2023-11-29",
        "certification_date": "2023-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MD",
            "license": "R070205",
            "primary": true
        },
        {
            "code": "207LC0200X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Critical Care Medicine",
            "state": "MD",
            "license": "R070205",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST BC BS",
            "identifier": "53641602",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "812114100",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Reginald Scott Widemon
• David Michael Widlus, M.D.
• Nancy Widlus, LCSW-C
• Patricia Ferrie Widra, M.D.
• Shelly A. Wiechelt, PH.D., LCSW-C, CCDC
• Paige Wieczorek
• Lindsey Wiedel
• Deirdre Wiederrecht, CRNP
• Tessa Wiedl, RD, LDN
• Brett A Wiegrefe, PT

• Pediatric Nurse Practitioner in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Pediatric Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.