Individual provider Active NPI

Debbie L Boyd, CRNP

  • Obstetrics & Gynecology Nurse Practitioner
  • Havre de Grace, MD
National Provider Identifier
1700873452
Registry record updated Apr 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology Nurse PractitionerTaxonomy code 363LX0001X
License
R063275 Issued in MD
Practice address
308 N Union Ave
Havre de Grace, MD 21078-2825
Phone
(410) 939-3121
Fax
(410) 939-8278
NPI assigned
Sep 28, 2005
Last updated
Apr 18, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Nurse Practitioner 363LX0001X R063275 MD Primary

Addresses

Primary practice location

308 N Union Ave
Havre de Grace, MD 21078-2825

Mailing address

PO Box 420
Havre de Grace, MD 21078-0420
Phone (410) 939-3121

Other identifiers 1

IdentifierTypeStateIssuer
499251203MedicaidMD

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
I20101027000813 MD Practitioner - Nurse Practitioner 0345434015 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group, LLC CurrentSince Jan 26, 2016 Accepting new patients
Susquehanna OB-GYN LLC CurrentSince Feb 1, 1993 Accepting new patients
Privia Medical Group, LLC CurrentSince Jan 26, 2016 Accepting new patients

Locations

133 Defense Hwy
Ste 112
Annapolis, MD 21401
Phone (410) 573-0140

520 Upper Chesapeake Dr
Ste 301
Bel Air, MD 21014
Phone (410) 643-4300

308 N Union Ave
Hvre de Grace, MD 21078
Phone (410) 939-3121

11350 Pembrooke Sq
Ste 304
Waldorf, MD 20603
Phone (301) 856-2810

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1127865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1303084800000",
    "number": "1700873452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 420",
            "city": "HAVRE DE GRACE",
            "state": "MD",
            "postal_code": "210780420",
            "telephone_number": "410-939-3121",
            "fax_number": "410-939-8278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "308 N UNION AVE",
            "city": "HAVRE DE GRACE",
            "state": "MD",
            "postal_code": "210782825",
            "telephone_number": "410-939-3121",
            "fax_number": "410-939-8278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOYD",
        "first_name": "DEBBIE",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-28",
        "last_updated": "2011-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LX0001X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "MD",
            "license": "R063275",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "499251203",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Havre de Grace, MD

Sources for this page

Verify at the official NPI Registry.