Individual provider Active NPI

Nastassja Crawford, CPNP-PC

  • Pediatric Nurse Practitioner
  • Baltimore, MD
National Provider Identifier
1720769359
Registry record updated Aug 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
AC005721 Issued in MD
Practice address
3001 S Hanover St Ste 108
Baltimore, MD 21225-1233
Phone
(410) 350-2173
NPI assigned
Jul 27, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X AC005721 MD Primary

Addresses

Primary practice location

3001 S Hanover St Ste 108
Baltimore, MD 21225-1233

Mailing address

135 Bent Creek LN
Jackson, TN 38305-2119

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
I20230929000368 MD Practitioner - Nurse Practitioner 6507210218 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AC005721MDMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Park Heights Medical Clinic LLC CurrentSince Aug 14, 2023 Accepting new patients
Hollis Seunarine Mdpa LLC PastSince Aug 24, 2025 Accepting new patients

Locations

5010 York Rd
Baltimore, MD 21212
Phone (410) 433-2200

4340 Park Heights Ave
Baltimore, MD 21215
Phone (410) 542-8130

301 International Cir
Hunt Valley, MD 21030
Phone (410) 433-2200

Organizations & group practices 2

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": "1690416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788134400000",
    "number": "1720769359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 BENT CREEK LN",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383052119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3001 S HANOVER ST STE 108",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212251233",
            "telephone_number": "410-350-2173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRAWFORD",
        "first_name": "NASTASSJA",
        "credential": "CPNP-PC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-27",
        "last_updated": "2026-08-31",
        "certification_date": "2026-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MD",
            "license": "AC005721",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.