Individual provider Active NPI

Krista Brown, CRNP

  • Adult Health Nurse Practitioner
  • Baltimore, MD
National Provider Identifier
1699771428
Registry record updated Sep 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
R146338 Issued in MD
Practice address
29 S Paca St
Baltimore, MD 21201-1771
Phone
(410) 328-6792
Fax
(410) 328-8726
NPI assigned
Jun 27, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X SP008493 PA
Adult Health Nurse Practitioner 363LA2200X R146338 MD Primary

Addresses

Primary practice location

29 S Paca St
Baltimore, MD 21201-1771

Mailing address

PO Box 64380
Baltimore, MD 21264-4380
Phone (410) 328-6792

Other identifiers 2

IdentifierTypeStateIssuer
4101201-00MedicaidMD
882775-01OtherMDBC/BS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20181026001465 TX Practitioner - Nurse Practitioner 4486692910 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Winslow Indian Health Care Center, Inc Current Accepting new patients
Dilkon Medical Center Current Accepting new patients
Winslow Indian Health Care Center, Inc CurrentSince Sep 10, 2018 Accepting new patients
Winslow Indian Health Care Center, Inc CurrentSince Sep 10, 2018 Accepting new patients

Locations

500 Indiana Ave
Winslow, AZ 86047

1501 N Williamson Ave
Winslow, AZ 86047
Phone (928) 289-4691

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1119830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1220918400000",
    "number": "1699771428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 64380",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212644380",
            "telephone_number": "410-328-6792",
            "fax_number": "410-328-8726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29 S PACA ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212011771",
            "telephone_number": "410-328-6792",
            "fax_number": "410-328-8726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "KRISTA",
        "name_prefix": "Mrs.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-27",
        "last_updated": "2008-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "PA",
            "license": "SP008493",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MD",
            "license": "R146338",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4101201-00",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "882775-01",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.