NPIMap

Individual provider Active NPI

Julie Christine Henne-Reese, C.R.N.P

  • Family Nurse Practitioner
  • Centreville, MD
National Provider Identifier
1669473948
Registry record updated Feb 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R130914 Issued in MD
Practice address
129 Banbridge Ave
Centreville, MD 21617-2346
Phone
(667) 358-0287
Fax
(410) 304-0277
NPI assigned
Aug 9, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R130914 MD Primary

Addresses

Primary practice location

129 Banbridge Ave
Centreville, MD 21617-2346

Mailing address

129 Banbridge Ave
Centreville, MD 21617-2346
Phone (667) 358-0287

Other practice location 1

125 Shoreway Dr Ste 120
Queenstown, MD 21658-1681
Phone (410) 827-4001

Other identifiers 8

IdentifierTypeStateIssuer
100168OtherMDJHHC PROVIDER NUMBER
1970965OtherMDAETNA HMO
9326221OtherMDAETNA PPO
369040700MedicaidMD
500027792OtherMDRR MEDICARE
447062100MedicaidMD
615790-02OtherMDCAREFIRST MD RENDERING
7605-0052OtherMDCAREFIRST BLUECHOICE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100714000350 MD Practitioner - Nurse Practitioner 8123150919 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

Centreville, MD 21617
Phone (667) 358-0287

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
New Wave in Home Medical Care Family CurrentSince Aug 1, 2023 Accepting new patients
Maryland Primary Care Physicians, LLC CurrentSince Dec 25, 2023 Accepting new patients

Locations

7580 Buckingham Blvd
Ste 220
Hanover, MD 21076
Phone (410) 729-5100

1111 Benfield Blvd
Ste 200
Millersville, MD 21108
Phone (410) 729-5100

125 Shoreway Dr
Ste 120
Queenstown, MD 21658
Phone (410) 643-7800

Interoperability endpoints

  • Direct secure messaging: julie.henne-reese@625637908152324.direct.elationemr.com

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.

Hospital & facility affiliations 10

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": "1123545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706832000000",
    "number": "1669473948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "129 BANBRIDGE AVE",
            "city": "CENTREVILLE",
            "state": "MD",
            "postal_code": "216172346",
            "telephone_number": "667-358-0287",
            "fax_number": "410-304-0277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "129 BANBRIDGE AVE",
            "city": "CENTREVILLE",
            "state": "MD",
            "postal_code": "216172346",
            "telephone_number": "667-358-0287",
            "fax_number": "410-304-0277"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "125 Shoreway Dr Ste 120",
            "address_purpose": "LOCATION",
            "city": "Queenstown",
            "state": "MD",
            "postal_code": "216581681",
            "country_code": "US",
            "telephone_number": "410-827-4001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HENNE-REESE",
        "first_name": "JULIE",
        "middle_name": "CHRISTINE",
        "name_prefix": "Ms.",
        "credential": "C.R.N.P",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-09",
        "last_updated": "2024-02-02",
        "certification_date": "2024-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R130914",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JHHC PROVIDER NUMBER",
            "identifier": "100168",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO",
            "identifier": "1970965",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PPO",
            "identifier": "9326221",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "369040700",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "500027792",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "447062100",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST MD RENDERING",
            "identifier": "615790-02",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST BLUECHOICE",
            "identifier": "7605-0052",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Centreville, MD

Sources for this page

Verify at the official NPI Registry.