Individual provider Active NPI

Voshty La'Dazia Christopher, CRNP-PMH

  • Psychiatric/Mental Health Nurse Practitioner
  • Berlin, MD
National Provider Identifier
1811764384
Registry record updated Jul 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
R237271 Issued in MD
Practice address
10344 Old Ocean City Blvd Ste 2
Berlin, MD 21811-1162
Phone
(410) 641-3340
Fax
(410) 641-3341
NPI assigned
Dec 5, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X R237271 MD Primary

Addresses

Primary practice location

10344 Old Ocean City Blvd Ste 2
Berlin, MD 21811-1162

Mailing address

PO Box 1978
Salisbury, MD 21802-1978
Phone (410) 749-1015

Other identifiers 1

IdentifierTypeStateIssuer
119591300MedicaidMD

Other names 1

  • Ms. Vashty La'Dazia Christopher Other name

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
I20240218000052 MD Practitioner - Nurse Practitioner 9133563125 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Three Lower Counties Community Services, Inc. CurrentSince Mar 18, 2024 Accepting new patients
Three Lower Counties Community Services, Inc. CurrentSince Mar 18, 2024 Accepting new patients
Three Lower Counties Community Services Inc Current Accepting new patients

Locations

10344 Old Ocean City Blvd
Ste 2
Berlin, MD 21811
Phone (410) 641-0430

9714 Healthway Dr
Berlin, MD 21811
Phone (410) 641-2600

12137 Elm St
Princess Anne, MD 21853
Phone (410) 651-1000

Interoperability endpoints

  • Direct secure messaging: voshty.christopher.1@3167.direct.athenahealth.com

Organizations & group practices 3

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": "1701734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720656000000",
    "number": "1811764384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1978",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218021978",
            "telephone_number": "410-749-1015",
            "fax_number": "410-749-0654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10344 OLD OCEAN CITY BLVD STE 2",
            "city": "BERLIN",
            "state": "MD",
            "postal_code": "218111162",
            "telephone_number": "410-641-3340",
            "fax_number": "410-641-3341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHRISTOPHER",
        "first_name": "VOSHTY",
        "middle_name": "LA'DAZIA",
        "name_prefix": "Ms.",
        "credential": "CRNP-PMH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-12-05",
        "last_updated": "2024-07-11",
        "certification_date": "2024-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R237271",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "119591300",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VASHTY",
            "last_name": "CHRISTOPHER",
            "middle_name": "LA'DAZIA",
            "prefix": "MS.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Berlin, MD

Sources for this page

Verify at the official NPI Registry.