Individual provider Active NPI

Kristen Elizabeth Tweedy, NP-C

  • Adult Health Nurse Practitioner
  • Baltimore, MD
National Provider Identifier
1659550036
Registry record updated Jan 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
R234312 Issued in MD
Practice address
600 N Wolfe St
Baltimore, MD 21287-0005
Phone
(410) 502-5999
Fax
(410) 955-2098
NPI assigned
Nov 1, 2007
Last updated
Jan 12, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 4704187521 MI
Adult Health Nurse Practitioner 363LA2200X R234312 MD Primary

Addresses

Primary practice location

600 N Wolfe St
Baltimore, MD 21287-0005

Mailing address

6201 Greenleigh Ave
Middle River, MD 21220-2004
Phone (410) 933-6423

Other practice location 1

5301 E Huron River Dr
Suite C-139
Ypsilanti, MI 48197-1051
Phone (734) 712-1000

Other practice location 2

1100 E Michigan Ave Ste 307
Jackson, MI 49201-1850
Phone (517) 205-1594

Other names 1

  • Kristen Elizabeth Park Former name

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
I20190402000016 MD Practitioner - Nurse Practitioner 8426135716 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2007
Medicare assignment
May accept Medicare assignment
Group practices
Johns Hopkins UniversityGroup PAC ID 4981745098, shared by 45 NPIs, 711 clinicians
Johns Hopkins UniversityGroup PAC ID 8921903147, 2,886 clinicians

Practice addresses (Care Compare)

600 N Wolf St
Baltimore, MD 21287-0005
Phone (410) 955-5000

600 N Wolfe St
Blalock 266
Baltimore, MD 21287-0005
Phone (410) 502-4340

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.31 of 100Reported as group
Quality
73.89
Promoting interoperability
100
Improvement activities
40
Cost
70.47

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R234312MDMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Johns Hopkins University CurrentSince Dec 1, 2020 Accepting new patients
Johns Hopkins University CurrentSince Feb 4, 2019 Accepting new patients
Johns Hopkins University CurrentSince Feb 4, 2019 Accepting new patients
Johns Hopkins University CurrentSince Mar 1, 2020 Accepting new patients
Johns Hopkins University CurrentSince Dec 1, 2020 Accepting new patients
Johns Hopkins University CurrentSince Dec 1, 2020 Accepting new patients
Johns Hopkins University Current Accepting new patients

Locations

5601 Loch Raven Blvd
Baltimore, MD 21239
Phone (443) 444-4714

600 N Wolfe St
Baltimore, MD 21287

6201 Greenleigh Ave
Middle River, MD 21220
Phone (410) 933-2704

Interoperability endpoints

  • Direct secure messaging: ktweedy469817@direct.hopkinsmedicine.org

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 1

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": "1193875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610409600000",
    "number": "1659550036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6201 GREENLEIGH AVE",
            "city": "MIDDLE RIVER",
            "state": "MD",
            "postal_code": "212202004",
            "telephone_number": "410-933-6423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 N WOLFE ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212870005",
            "telephone_number": "410-502-5999",
            "fax_number": "410-955-2098"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5301 E Huron River Dr",
            "address_2": "Suite C-139",
            "address_purpose": "LOCATION",
            "city": "Ypsilanti",
            "state": "MI",
            "postal_code": "481971051",
            "country_code": "US",
            "telephone_number": "734-712-1000",
            "fax_number": "734-712-1012",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1100 E Michigan Ave Ste 307",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "MI",
            "postal_code": "492011850",
            "country_code": "US",
            "telephone_number": "517-205-1594",
            "fax_number": "517-205-5229",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TWEEDY",
        "first_name": "KRISTEN",
        "middle_name": "ELIZABETH",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-01",
        "last_updated": "2021-01-12",
        "certification_date": "2021-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MI",
            "license": "4704187521",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MD",
            "license": "R234312",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTEN",
            "last_name": "PARK",
            "middle_name": "ELIZABETH",
            "credential": "NP-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.