Individual provider Active NPI

Sarah Elizabeth Nelson, PA

  • Physician Assistant
  • Baltimore, MD
National Provider Identifier
1770737736
Registry record updated Feb 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
C0006870 Issued in MD
Practice address
9524 Belair Rd
Baltimore, MD 21236-1544
Phone
(410) 529-9311
Fax
(410) 529-0085
NPI assigned
Nov 4, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X C0006870 MD Primary

Addresses

Primary practice location

9524 Belair Rd
Baltimore, MD 21236-1544

Mailing address

9524 Belair Rd
Baltimore, MD 21236-1544
Phone (410) 529-9311

Other identifiers 1

IdentifierTypeStateIssuer
1780644104MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20170920001247 NC Order and Referring Only - Physician Assistant 5193877579

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
102663NCMDPsychologist
C0006870MDMDPhysician Assistant

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1225756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550620800000",
    "number": "1770737736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9524 BELAIR RD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212361544",
            "telephone_number": "410-529-9311",
            "fax_number": "410-529-0085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9524 BELAIR RD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212361544",
            "telephone_number": "410-529-9311",
            "fax_number": "410-529-0085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "SARAH",
        "middle_name": "ELIZABETH",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-04",
        "last_updated": "2019-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C0006870",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1780644104",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.