Individual provider Active NPI

Andrea Leanoria Grant, FNP

  • Family Nurse Practitioner
  • Thurmont, MD
National Provider Identifier
1699584060
Registry record updated Mar 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2024097620 Issued in MD
Practice address
100 S Center St
Thurmont, MD 21788-1945
Phone
(301) 696-8801
Fax
(301) 696-0186
NPI assigned
Dec 31, 2024
Last updated
Mar 25, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2025

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 2024097620 MD Primary

Addresses

Primary practice location

100 S Center St
Thurmont, MD 21788-1945

Mailing address

9369 Highlander Blvd
Walkersville, MD 21793-9114
Phone (301) 730-1442

Other practice location 1

9369 Highlander Blvd
Walkersville, MD 21793-9114
Phone (301) 730-1442

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
I20250321000702 MD Practitioner - Nurse Practitioner 5698297489 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Amber Hill Physical Therapy IncGroup PAC ID 8527963917, 336 clinicians
Praveen Bolarum MD LLCGroup PAC ID 9638276199, 5 clinicians

Practice addresses (Care Compare)

187 Thomas Johnson Dr
Suite 6
Frederick, MD 21702-4503

196 Thomas Johnson Dr
Frederick, MD 21702-4518
Phone (301) 694-6688

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2024097620MDMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Praveen Bolarum, MD LLC CurrentSince Jun 24, 2025 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Virtue Primary Care LLC Family PastSince Jan 1, 2025 Accepting new patients

Locations

196 Thomas Johnson Dr
Ste 135
Frederick, MD 21702
Phone (301) 662-3660

Organizations & group practices 4

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": "1735603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742860800000",
    "number": "1699584060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9369 HIGHLANDER BLVD",
            "city": "WALKERSVILLE",
            "state": "MD",
            "postal_code": "217939114",
            "telephone_number": "301-730-1442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 S CENTER ST",
            "city": "THURMONT",
            "state": "MD",
            "postal_code": "217881945",
            "telephone_number": "301-696-8801",
            "fax_number": "301-696-0186"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9369 Highlander Blvd",
            "address_purpose": "LOCATION",
            "city": "Walkersville",
            "state": "MD",
            "postal_code": "217939114",
            "country_code": "US",
            "telephone_number": "301-730-1442",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRANT",
        "first_name": "ANDREA",
        "middle_name": "LEANORIA",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-12-31",
        "last_updated": "2025-03-25",
        "certification_date": "2025-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "2024097620",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Thurmont, MD

Sources for this page

Verify at the official NPI Registry.