Individual provider Active NPI

Nardos Zelleke Bellete

  • Clinical Psychologist
  • Columbia, MD
National Provider Identifier
1780253708
Registry record updated Jun 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
06911 Issued in MD
Practice address
9810 Patuxent Woods Dr
Columbia, MD 21046-1595
Phone
(443) 923-4360
NPI assigned
Jun 23, 2021
Last updated
Jun 13, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 06911 MD Primary

Addresses

Primary practice location

9810 Patuxent Woods Dr
Columbia, MD 21046-1595

Mailing address

1741 Ashland Ave
Baltimore, MD 21205-1531
Phone (443) 923-1870

Other practice location 1

707 N Broadway
Baltimore, MD 21205-1832
Phone (443) 923-9200

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231101001063 MD Practitioner - Clinical Psychologist 3870949530 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Kennedy Krieger Associates CurrentSince Sep 12, 2023 Accepting new patients
Kennedy Krieger Associates CurrentSince Sep 12, 2023 Accepting new patients

Locations

1741 Ashland Ave
Baltimore, MD 21205
Phone (443) 923-1842

1741 Ashland Ave
Rm 646
Baltimore, MD 21205
Phone (443) 923-1842

707 N Broadway
Baltimore, MD 21205
Phone (443) 923-1870

9810 Patuxent Woods Dr
Columbia, MD 21046
Phone (443) 923-3895

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

NPI Registry JSON

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

{
    "created_epoch": "1624406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686614400000",
    "number": "1780253708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1741 ASHLAND AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212051531",
            "telephone_number": "443-923-1870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9810 PATUXENT WOODS DR",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210461595",
            "telephone_number": "443-923-4360"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "707 N Broadway",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212051832",
            "country_code": "US",
            "telephone_number": "443-923-9200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BELLETE",
        "first_name": "NARDOS",
        "middle_name": "ZELLEKE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-23",
        "last_updated": "2023-06-13",
        "certification_date": "2023-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MD",
            "license": "06911",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MD

Sources for this page

Verify at the official NPI Registry.