Individual provider Active NPI

Jessica Kwebetchou

  • Nurse Practitioner
  • Towson, MD
National Provider Identifier
1811885502
Registry record updated Jun 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
R193212 Issued in MD
Practice address
6535 N Charles St Ste 500
Towson, MD 21204-5832
Phone
(410) 825-5454
NPI assigned
Jun 24, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2025

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 R193212 MD Primary

Addresses

Primary practice location

6535 N Charles St Ste 500
Towson, MD 21204-5832

Mailing address

10200 Grand Central Ave Ste 220
Owings Mills, MD 21117-4366
Phone (443) 471-5783

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
I20250925002684 MD Practitioner - Nurse Practitioner 7416452941 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Chesapeake Urology Associates LLCGroup PAC ID 4789673393, 161 clinicians

Practice addresses (Care Compare)

6535 N Charles St
Suite 500
Towson, MD 21204-5832
Phone (410) 825-5454

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R193212MDMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Chesapeake Urology Associates, LLC CurrentSince Jul 12, 2025 Accepting new patients
Chesapeake Urology Associates, LLC Current Accepting new patients
Chesapeake Urology Associates LLC CurrentSince Jul 12, 2025 Accepting new patients
Chesapeake Urology Associates, LLC Past Accepting new patients

Locations

10200 Grand Central Ave
Ste 220
Owings Mills, MD 21117

1838 Greene Tree Rd
Ste 460
Pikesville, MD 21208
Phone (410) 581-8140

1111 Mount Hermon Rd
#A
Salisbury, MD 21804
Phone (410) 546-2133

6535 N Charles St
Ste 500
Towson, MD 21204
Phone (410) 296-4181

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": "1750723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750723200000",
    "number": "1811885502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10200 GRAND CENTRAL AVE STE 220",
            "city": "OWINGS MILLS",
            "state": "MD",
            "postal_code": "211174366",
            "telephone_number": "443-471-5783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6535 N CHARLES ST STE 500",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212045832",
            "telephone_number": "410-825-5454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KWEBETCHOU",
        "first_name": "JESSICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-24",
        "last_updated": "2025-06-24",
        "certification_date": "2025-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MD",
            "license": "R193212",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Towson, MD

Sources for this page

Verify at the official NPI Registry.