Individual provider Active NPI

Andrea Elizabeth Speedie, MD

  • Family Medicine Physician
  • Baltimore, MD
National Provider Identifier
1760632079
Registry record updated Sep 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
D0068059 Issued in MD
Practice address
1111 N. Charles St.
Baltimore, MD 21201-5442
Phone
(410) 837-2050
Fax
(410) 837-2071
NPI assigned
Sep 23, 2008
Last updated
Sep 19, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X D0068059 MD Primary

Addresses

Primary practice location

1111 N. Charles St.
Baltimore, MD 21201-5442

Mailing address

1111 N. Charles St.
Baltimore, MD 21201-5442
Phone (410) 837-2050

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100910000080 MD Practitioner - Family Practice 1951426287 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Johns Hopkins University School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Chase Brexton Health Services IncGroup PAC ID 5395644835, 119 clinicians

Practice addresses (Care Compare)

1111 N Charles St
Baltimore, MD 21201-5505
Phone (410) 837-2050

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
D0068059MDMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Chase Brexton Health Services, Inc. CurrentSince Jul 1, 2010 Accepting new patients
Chase Brexton Health Services, Inc. CurrentSince Jul 1, 2010 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

1111 N Charles St
Baltimore, MD 21201
Phone (410) 486-5991

5500 Knoll North Dr
Ste 370
Columbia, MD 21045
Phone (410) 884-7831

6901 Security Blvd
Ste 200
Windsor Mill, MD 21244

Organizations & group practices 3

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 2

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": "1222128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379548800000",
    "number": "1760632079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 N. CHARLES ST.",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212015442",
            "telephone_number": "410-837-2050",
            "fax_number": "410-837-2071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 N. CHARLES ST.",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212015442",
            "telephone_number": "410-837-2050",
            "fax_number": "410-837-2071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPEEDIE",
        "first_name": "ANDREA",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-23",
        "last_updated": "2013-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MD",
            "license": "D0068059",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.