Individual provider Active NPI

Christina Husemann, FNP

  • Family Nurse Practitioner
  • Havre de Grace, MD
National Provider Identifier
1649832700
Registry record updated Jul 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R197596 Issued in MD
Practice address
669 Revolution St
Havre de Grace, MD 21078-3319
Phone
(410) 939-2840
NPI assigned
Jun 28, 2019
Last updated
Jul 10, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R197596 MD Primary
Registered Nurse 163W00000X R197596 MD

Addresses

Primary practice location

669 Revolution St
Havre de Grace, MD 21078-3319

Mailing address

669 Revolution St
Havre de Grace, MD 21078-3319

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
I20191010002812 MD Practitioner - Nurse Practitioner 9032440755 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Privia Care Center LLCGroup PAC ID 3274801139, 286 clinicians
Agape Physical Therapy and Sports Rehabilitation LPGroup PAC ID 3870741390, 684 clinicians

Practice addresses (Care Compare)

110 Baughmans LN
Suite 140
Frederick, MD 21702-4649
Phone (240) 215-1138

12 Newport Dr
Suite a
Forest Hill, MD 21050-1758

301 Saint Paul St
Suite 409
Baltimore, MD 21202-2102
Phone (410) 659-7041

669 Revolution St
Havre de Grace, MD 21078-3319
Phone (410) 939-2840

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group, LLC Current Accepting new patients
Menocal Medical Services PA Current Accepting new patients
Privia Medical Group, LLC CurrentSince Aug 14, 2019 Accepting new patients
Privia Care Center LLC CurrentSince Aug 14, 2019 Accepting new patients
Privia Care Center LLC CurrentSince Aug 14, 2019 Accepting new patients
Privia Medical Group, LLC CurrentSince Aug 14, 2019 Accepting new patients

Locations

133 Defense Hwy
Ste 112
Annapolis, MD 21401
Phone (410) 573-0140

301 Saint Paul St
Ste 409
Baltimore, MD 21202
Phone (410) 659-7041

110 Baughmans Ln
Ste 140
Frederick, MD 21702

669 Revolution St
Hvre de Grace, MD 21078
Phone (410) 939-0167

950 N Glebe Rd
Ste 700
Arlington, VA 22203
Phone (484) 228-1065

Interoperability endpoints

  • Direct secure messaging: christina.husemann.1@8042.direct.athenahealth.com

Organizations & group practices 7

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1561680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562716800000",
    "number": "1649832700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "669 REVOLUTION ST",
            "city": "HAVRE DE GRACE",
            "state": "MD",
            "postal_code": "210783319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "669 REVOLUTION ST",
            "city": "HAVRE DE GRACE",
            "state": "MD",
            "postal_code": "210783319",
            "telephone_number": "410-939-2840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUSEMANN",
        "first_name": "CHRISTINA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-28",
        "last_updated": "2019-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R197596",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MD",
            "license": "R197596",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Havre de Grace, MD

Sources for this page

Verify at the official NPI Registry.