Individual provider Active NPI

Mary Ann Wippel, CRNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Lutherville, MD
National Provider Identifier
1730361510
Registry record updated Jan 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
R115364 Issued in MD
Practice address
1447 York Rd Ste 506
Lutherville, MD 21093-6022
Phone
(410) 825-2281
Fax
(410) 825-2280
NPI assigned
Dec 3, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 9, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X R115364 MD Primary

Addresses

Primary practice location

1447 York Rd Ste 506
Lutherville, MD 21093-6022

Mailing address

1145 Main St
Darlington, MD 21034-1405
Phone (410) 457-4689

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
I20110113000586 MD Practitioner - Nurse Practitioner 9830388453 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2401 E Belvedere Ave
Baltimore, MD 21215-5216
Phone (410) 601-9000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.23 of 100Reported as group
Quality
60.26
Promoting interoperability
100
Improvement activities
40
Cost
76.75

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R115364MDMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lifebridge Community Physicians Inc CurrentSince Apr 30, 2022 Accepting new patients
Lifebridge Community Physicians Inc CurrentSince Apr 30, 2022 Accepting new patients
Lifebridge Community Physicians, Inc Current Accepting new patients
Five Star Physician Services, LLC CurrentSince Sep 15, 2010 Accepting new patients

Locations

2401 W Belvedere Ave
Baltimore, MD 21215

785 Elkridge Landing Rd
Ste 300
Linthicum Heights, MD 21090
Phone (443) 323-3014

410 Malcolm Dr
Ste A
Westminster, MD 21157
Phone (410) 876-1633

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1196640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546992000000",
    "number": "1730361510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1145 MAIN ST",
            "city": "DARLINGTON",
            "state": "MD",
            "postal_code": "210341405",
            "telephone_number": "410-457-4689",
            "fax_number": "410-457-4689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1447 YORK RD STE 506",
            "city": "LUTHERVILLE",
            "state": "MD",
            "postal_code": "210936022",
            "telephone_number": "410-825-2281",
            "fax_number": "410-825-2280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIPPEL",
        "first_name": "MARY",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "CRNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-12-03",
        "last_updated": "2019-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R115364",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lutherville, MD

Sources for this page

Verify at the official NPI Registry.