Active NPI
Laura Boeckner, CRNP
- Pediatric Nurse Practitioner
- Marriottsville, MD
National Provider Identifier
1699199521
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- R197113
- Practice address
- 11185 Stratfield CT
Marriottsville, MD 21104-1659 - Phone
- (410) 442-4011
- NPI assigned
- Feb 12, 2014
- Last updated
- Oct 26, 2021
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | R197113 | MD | Primary |
Addresses
Primary practice location
11185 Stratfield CT
Marriottsville, MD 21104-1659
Mailing address
34 E Heath St
Baltimore, MD 21230-4840
Phone (308) 631-7455
Other practice location 1
34 E Heath St
Baltimore, MD 21230-4840
Phone (308) 631-7455
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 806202100 | Medicaid | MD |
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
| License | State | Type | Specialty |
|---|---|---|---|
| R197113 | MD | MD | Pediatric Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Alvaro F Ramos MD PC | Past | Accepting new patients |
Interoperability endpoints
- boecknercrnp@marylandpediatrics.opdirect.net
Organizations & group practices 1
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.
-
dba Maryland Pediatrics
- Pediatric Adolescent Medicine Physician
- Marriottsville, MD
- NPI 1861659922
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1392163200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1635206400000",
"number": "1699199521",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "34 E HEATH ST",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212304840",
"telephone_number": "308-631-7455"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11185 STRATFIELD CT",
"city": "MARRIOTTSVILLE",
"state": "MD",
"postal_code": "211041659",
"telephone_number": "410-442-4011"
}
],
"practiceLocations": [
{
"address_1": "34 E Heath St",
"address_purpose": "LOCATION",
"city": "Baltimore",
"state": "MD",
"postal_code": "212304840",
"country_code": "US",
"telephone_number": "308-631-7455",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BOECKNER",
"first_name": "LAURA",
"credential": "CRNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-02-12",
"last_updated": "2021-10-26",
"certification_date": "2021-10-26",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "MD",
"license": "R197113",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "806202100",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}Other providers in Marriottsville, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.