Individual provider Active NPI

Ann Henderson, CRNP

  • Nurse Practitioner
  • Columbia, MD
National Provider Identifier
1720054620
Registry record updated Oct 23, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
R128848 Issued in MD
Practice address
11065 Little Patuxent Pkwy
Columbia, MD 21044-2998
Phone
(410) 328-3037
Fax
(410) 328-3040
NPI assigned
Feb 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X R128848 MD Primary

Addresses

Primary practice location

11065 Little Patuxent Pkwy
Columbia, MD 21044-2998

Mailing address

PO Box 64620
Baltimore, MD 21264-4620
Phone (410) 328-3037

Other identifiers 1

IdentifierTypeStateIssuer
R128848OtherMDMD BOARD OF NURSING LICEN

Other names 1

  • Elizabeth Henderson Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20070928000468 MD Practitioner - Nurse Practitioner 3476648916 Reassigns benefits to 1 organization
I20200131000856 DC Practitioner - Nurse Practitioner 3476648916 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carroll Regional Cancer Center Physicians, LLCGroup PAC ID 5092987354, 5 clinicians

Practice addresses (Care Compare)

291 Stoner Ave
Westminster, MD 21157-5647
Phone (410) 871-6400

Hospital & facility affiliations

  • Sinai Hospital of Baltimore Hospital, Baltimore, MD, CCN 210012
  • Carroll Hospital Center Hospital, Westminster, MD, CCN 210033

Merit-based Incentive Payment System (MIPS)

Final score
85.83 of 100Reported as group
Quality
71.66
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
85.03 of 100Reported as group
Quality
71.4
Promoting interoperability
100
Improvement activities
40
Cost
73.75

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R128848MDMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Maryland Oncology Hematology P.a. CurrentSince Dec 14, 2019 Accepting new patients
Maryland Oncology Hematology, P.a. Current Accepting new patients
Maryland Oncology Hematology P.a. CurrentSince Dec 14, 2019 Accepting new patients
Mid-Atlantic Oncology Hematology, LLC CurrentSince Dec 14, 2019 Accepting new patients
Carroll Regional Cancer Center Physicians, LLC CurrentSince Jun 1, 2024 Accepting new patients
University of Maryland Radiation Oncology Associates PA Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

11720 Beltsville Dr
Ste 211
Beltsville, MD 20705

11065 Little Patuxent Pkwy
Columbia, MD 21044
Phone (410) 740-9300

12200 Annapolis Rd
Ste 118
Glenn Dale, MD 20769
Phone (410) 897-6200

7350 Van Dusen Rd
Ste 370
Laurel, MD 20707
Phone (301) 982-9800

291 Stoner Ave
Westminster, MD 21157
Phone (410) 871-6139

Organizations & group practices 7

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.

Hospital & facility affiliations 3

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": "1141084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193097600000",
    "number": "1720054620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 64620",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212644620",
            "telephone_number": "410-328-3037",
            "fax_number": "410-328-3040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11065 LITTLE PATUXENT PKWY",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210442998",
            "telephone_number": "410-328-3037",
            "fax_number": "410-328-3040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "ANN",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-28",
        "last_updated": "2007-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MD",
            "license": "R128848",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MD BOARD OF NURSING LICEN",
            "identifier": "R128848",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "HENDERSON",
            "credential": "CRNP",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Columbia, MD

Sources for this page

Verify at the official NPI Registry.