Active NPI
Nicole K Dennis
- Family Medicine Physician
- Laurel, MD
National Provider Identifier
1679050462
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- R202121
- Practice address
- 9260 Canterbury Riding
Laurel, MD 20723-1425 - Phone
- (614) 579-9340
- NPI assigned
- Jul 24, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | R202121 | MD | Primary |
Addresses
Primary practice location
9260 Canterbury Riding
Laurel, MD 20723-1425
Mailing address
820 Bestgate Rd
Ste 2a
Annapolis, MD 21401-3404
Phone (410) 224-2116
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1532390400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1565049600000",
"number": "1679050462",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "820 BESTGATE RD",
"address_2": "STE 2A",
"city": "ANNAPOLIS",
"state": "MD",
"postal_code": "214013404",
"telephone_number": "410-224-2116",
"fax_number": "410-224-2118"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9260 CANTERBURY RIDING",
"city": "LAUREL",
"state": "MD",
"postal_code": "207231425",
"telephone_number": "614-579-9340"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DENNIS",
"first_name": "NICOLE",
"middle_name": "K",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-07-24",
"last_updated": "2019-08-06",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MD",
"license": "R202121",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Laurel, MD
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- Fnu Delphine Ntomne Ntoh
- Deluxe Home Health Care Services,LLC
- Deluxe Home Healthcare Services
- Deluxe Home Healthcare Services
- Dental Care of Laurel Lakes
- Dental Professionals of Maryland, Badger, P.C.
- Dentistry for Children of Maryland, LLC
- Dentistry for Children of Maryland, LLC
- Theresa Louise Deramo, M.AC. L.AC., DIPL.AC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.