Active NPI
Lynne P Soper, CRNP
- Pediatric Nurse Practitioner
- Frederick, MD
National Provider Identifier
1720253073
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- R106802
- Practice address
- 87 Thomas Johnson Dr
Suite 101
Frederick, MD 21702-4427 - Phone
- (301) 694-0606
- Fax
- (301) 662-6928
- NPI assigned
- Apr 28, 2008
- Last updated
- Mar 9, 2022
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | N34605 | MD | |
| Pediatric Nurse Practitioner | 363LP0200X | R106802 | MD | Primary |
Addresses
Primary practice location
87 Thomas Johnson Dr
Suite 101
Frederick, MD 21702-4427
Mailing address
87 Thomas Johnson Dr
Suite 101
Frederick, MD 21702-4427
Phone (301) 694-0606
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 |
|---|---|---|---|
| N34605 | MD | MD | Pediatric Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Frederick Health Hospital Inc | Past | Accepting new patients |
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 Frederick Health Hospital
- General Acute Care Hospital
- Frederick, MD
- NPI 1538165527
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1209340800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1646784000000",
"number": "1720253073",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "87 THOMAS JOHNSON DR",
"address_2": "SUITE 101",
"city": "FREDERICK",
"state": "MD",
"postal_code": "217024427",
"telephone_number": "301-694-0606",
"fax_number": "301-662-6928"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "87 THOMAS JOHNSON DR",
"address_2": "SUITE 101",
"city": "FREDERICK",
"state": "MD",
"postal_code": "217024427",
"telephone_number": "301-694-0606",
"fax_number": "301-662-6928"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SOPER",
"first_name": "LYNNE",
"middle_name": "P",
"credential": "CRNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-04-28",
"last_updated": "2022-03-09",
"certification_date": "2022-03-09",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "MD",
"license": "N34605",
"primary": false
},
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "MD",
"license": "R106802",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Frederick, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.