Individual provider Active NPI

Patricia Joele Raymond, AGPCNP-BC

  • Adult Health Nurse Practitioner
  • Waldorf, MD
National Provider Identifier
1740787084
Registry record updated Apr 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
R186507 Issued in MD
Practice address
4772 Monterey CT
Waldorf, MD 20602-5115
Phone
(301) 785-3856
NPI assigned
Apr 12, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X R186507 MD Primary

Addresses

Primary practice location

4772 Monterey CT
Waldorf, MD 20602-5115

Mailing address

4772 Monterey CT
Waldorf, MD 20602-5115
Phone (301) 785-3856

Other names 1

  • Mrs. Patricia Joele Perrin Former name

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
I20190308001003 MD Practitioner - Nurse Practitioner 9436409323 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R186507MDMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University of Maryland Community Medical Group, Inc. CurrentSince Jul 12, 2021 Accepting new patients
University of Maryland Community Medical Group, Inc. CurrentSince Jul 12, 2021 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
NP Compassionate Care, LLC PastSince May 16, 2021 Accepting new patients

Locations

2540 Centreville Rd
Centreville, MD 21617
Phone (410) 758-4432

219 S Washington St
Easton, MD 21601

301 Hospital Dr
Glen Burnie, MD 21061
Phone (410) 787-4565

5 N La Plata Ct
Ste 101
La Plata, MD 20646
Phone (301) 609-5044

Organizations & group practices 5

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": "1523491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619654400000",
    "number": "1740787084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4772 MONTEREY CT",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206025115",
            "telephone_number": "301-785-3856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4772 MONTEREY CT",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206025115",
            "telephone_number": "301-785-3856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAYMOND",
        "first_name": "PATRICIA",
        "middle_name": "JOELE",
        "name_prefix": "Ms.",
        "credential": "AGPCNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-12",
        "last_updated": "2021-04-29",
        "certification_date": "2021-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MD",
            "license": "R186507",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PATRICIA",
            "last_name": "PERRIN",
            "middle_name": "JOELE",
            "prefix": "MRS.",
            "credential": "AGPCNP-BC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Waldorf, MD

Sources for this page

Verify at the official NPI Registry.