Individual provider Active NPI

Maureen Anne Fitzpatrick, C.R.N.P.

  • Nurse Practitioner
  • Baltimore, MD
National Provider Identifier
1790728640
Registry record updated Jun 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
R126860 Issued in MD
Practice address
3900 Loch Raven Blvd
Vamc - HBPC
Baltimore, MD 21218-2108
Phone
(410) 605-7620
Fax
(410) 605-7676
NPI assigned
Jun 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X R126860 MD Primary

Addresses

Primary practice location

3900 Loch Raven Blvd
Vamc - HBPC
Baltimore, MD 21218-2108

Mailing address

3900 Loch Raven Blvd
Vamc - HBPC
Baltimore, MD 21218-2108
Phone (410) 605-7620

Other identifiers 2

IdentifierTypeStateIssuer
404180100MedicaidMD
H897I074OtherMDPROVIDER NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R126860MDMDNurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1371427200000",
    "number": "1790728640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3900 LOCH RAVEN BLVD",
            "address_2": "VAMC - HBPC",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212182108",
            "telephone_number": "410-605-7620",
            "fax_number": "410-605-7676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3900 LOCH RAVEN BLVD",
            "address_2": "VAMC - HBPC",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212182108",
            "telephone_number": "410-605-7620",
            "fax_number": "410-605-7676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FITZPATRICK",
        "first_name": "MAUREEN",
        "middle_name": "ANNE",
        "credential": "C.R.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-14",
        "last_updated": "2013-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MD",
            "license": "R126860",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "404180100",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER NUMBER",
            "identifier": "H897I074",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.