Individual provider Active NPI

Wendy Marie Matthews, APRN

  • Nurse Practitioner
  • Silver Spring, MD
National Provider Identifier
1790338242
Registry record updated Mar 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
R161621 Issued in MD
Practice address
10750 Columbia Pike Ste 501
Silver Spring, MD 20901-4460
Phone
(301) 593-9035
Fax
(301) 593-9036
NPI assigned
Jul 23, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X R161621 MD
Nurse Practitioner 363L00000X R161621 MD Primary

Addresses

Primary practice location

10750 Columbia Pike Ste 501
Silver Spring, MD 20901-4460

Mailing address

1602 Earlham Ave
Crofton, MD 21114-1502

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
I20200203000999 MD Practitioner - Nurse Practitioner 4082040456 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Luminis Health Medical Group, LLC Current Accepting new patients
Luminis Health Medical Group, LLC CurrentSince Jan 19, 2020 Accepting new patients
Luminis Health Medical Group, LLC CurrentSince Jan 19, 2020 Accepting new patients

Locations

2003 Medical Pkwy
Ste 301
Annapolis, MD 21401
Phone (443) 481-3366

Interoperability endpoints

  • Direct secure messaging: wendy.matthews.1@17833.direct.athenahealth.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1563840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711324800000",
    "number": "1790338242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1602 EARLHAM AVE",
            "city": "CROFTON",
            "state": "MD",
            "postal_code": "211141502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10750 COLUMBIA PIKE STE 501",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209014460",
            "telephone_number": "301-593-9035",
            "fax_number": "301-593-9036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTHEWS",
        "first_name": "WENDY",
        "middle_name": "MARIE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-23",
        "last_updated": "2024-03-25",
        "certification_date": "2024-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MD",
            "license": "R161621",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MD",
            "license": "R161621",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Silver Spring, MD

Sources for this page

Verify at the official NPI Registry.