Individual provider Active NPI

Sherry Dong, BSN, RN, CCRN

  • Critical Care Medicine Registered Nurse
  • Baltimore, MD
National Provider Identifier
1790355105
Registry record updated Jun 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine Registered NurseTaxonomy code 163WC0200X
License
R230680 Issued in MD
Practice address
525 N Wolfe St
Baltimore, MD 21205-2110
Phone
(410) 955-4766
NPI assigned
Jun 28, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine Registered Nurse 163WC0200X 95175379 CA
Critical Care Medicine Registered Nurse 163WC0200X R230680 MD Primary

Addresses

Primary practice location

525 N Wolfe St
Baltimore, MD 21205-2110

Mailing address

8103 Ridgetown Dr Apt G
Nottingham, MD 21236-3515
Phone (626) 588-8090

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Bachelor on Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
95175379CAMDCritical Care Medicine Registered Nurse
R230680MDMDCritical Care Medicine Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1624838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624838400000",
    "number": "1790355105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8103 RIDGETOWN DR APT G",
            "city": "NOTTINGHAM",
            "state": "MD",
            "postal_code": "212363515",
            "telephone_number": "626-588-8090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 N WOLFE ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212052110",
            "telephone_number": "410-955-4766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DONG",
        "first_name": "SHERRY",
        "credential": "BSN, RN, CCRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-28",
        "last_updated": "2021-06-28",
        "certification_date": "2021-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "CA",
            "license": "95175379",
            "primary": false
        },
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "MD",
            "license": "R230680",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.