Individual provider Active NPI

Elena M. Dujordan, C.R.N.P.

  • Nurse Practitioner
  • Salisbury, MD
National Provider Identifier
1669558227
Registry record updated Dec 3, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
R152586 Issued in MD
Practice address
560 Riverside Dr
Suite a-204
Salisbury, MD 21801-4700
Phone
(410) 749-2922
Fax
(410) 546-0894
NPI assigned
Oct 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X R152586 MD Primary

Addresses

Primary practice location

560 Riverside Dr
Suite a-204
Salisbury, MD 21801-4700

Mailing address

560 Riverside Dr
Suite a-204
Salisbury, MD 21801-4700
Phone (410) 749-2922

Other identifiers 1

IdentifierTypeStateIssuer
R152586OtherMDSTATE LICENSE

Other names 1

  • Elena D. Bayline Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R152586MDMDNurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1161907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196640000000",
    "number": "1669558227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "560 RIVERSIDE DR",
            "address_2": "SUITE A-204",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218014700",
            "telephone_number": "410-749-2922",
            "fax_number": "410-546-0894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "560 RIVERSIDE DR",
            "address_2": "SUITE A-204",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218014700",
            "telephone_number": "410-749-2922",
            "fax_number": "410-546-0894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUJORDAN",
        "first_name": "ELENA",
        "middle_name": "M.",
        "credential": "C.R.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-27",
        "last_updated": "2007-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MD",
            "license": "R152586",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "R152586",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELENA",
            "last_name": "BAYLINE",
            "middle_name": "D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Salisbury, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.