Individual provider Active NPI

Jessica F Ditto, DNP, CPNP-PC, PMHS

  • Psychiatric/Mental Health Nurse Practitioner
  • Towson, MD
National Provider Identifier
1659434736
Registry record updated May 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
R131314 Issued in MD
Practice address
658 Kenilworth Dr Ste 206
Towson, MD 21204-2334
Phone
(443) 841-7550
Fax
(443) 841-7572
NPI assigned
Dec 19, 2006
Last updated
May 16, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X R131314 MD
Psychiatric/Mental Health Nurse Practitioner 363LP0808X R131314 MD Primary

Addresses

Primary practice location

658 Kenilworth Dr Ste 206
Towson, MD 21204-2334

Mailing address

658 Kenilworth Dr Ste 206
Towson, MD 21204-2334
Phone (443) 841-7550

Other identifiers 1

IdentifierTypeStateIssuer
410208800MedicaidMD

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
I20070830000547 MD Practitioner - Nurse Practitioner 8123111549 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Psychnp Wellness Center LLCGroup PAC ID 5890919625, 15 clinicians

Practice addresses (Care Compare)

658 Kenilworth Dr
Suite 206
Towson, MD 21204-2334
Phone (443) 841-7550

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R131314MDMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Psychnp Wellness Center, LLC Psychiatric/Mental Health CurrentSince Jun 27, 2023 Accepting new patients
American Psychiatric Care CurrentSince Jul 22, 2019 Accepting new patients
American Psychiatric Care Psychiatric/Mental Health CurrentSince Jul 22, 2019 Accepting new patients
Kennedy Krieger Associates CurrentSince Oct 26, 2015 Accepting new patients
Kennedy Krieger Associates CurrentSince Oct 26, 2015 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

2931 E Biddle St
Baltimore, MD 21213
Phone (443) 923-1872

707 N Broadway
Baltimore, MD 21205
Phone (443) 923-1870

2014 S Tollgate Rd
Ste 208
Bel Air, MD 21015
Phone (410) 670-3076

658 Kenilworth Dr
Ste 206
Towson, MD 21204
Phone (410) 828-3585

14631 Route 29
Ste 110
Centreville, VA 20121

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/19068/brand/1/csg/1/fhir/r4

Organizations & group practices 6

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": "1166486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684195200000",
    "number": "1659434736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "658 KENILWORTH DR STE 206",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212042334",
            "telephone_number": "443-841-7550",
            "fax_number": "443-841-7572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "658 KENILWORTH DR STE 206",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212042334",
            "telephone_number": "443-841-7550",
            "fax_number": "443-841-7572"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DITTO",
        "first_name": "JESSICA",
        "middle_name": "F",
        "name_prefix": "Dr.",
        "credential": "DNP, CPNP-PC, PMHS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-19",
        "last_updated": "2023-05-16",
        "certification_date": "2023-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MD",
            "license": "R131314",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R131314",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "410208800",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Towson, MD

Sources for this page

Verify at the official NPI Registry.