Individual provider Active NPI

Jenene McDowell

  • Psychiatric/Mental Health Nurse Practitioner
  • Baltimore, MD
National Provider Identifier
1821552282
Registry record updated Oct 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
R195903 Issued in MD
Practice address
4630 Belair Rd Ste a
Baltimore, MD 21206-6354
Phone
(443) 990-1710
NPI assigned
Jan 29, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 10, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X R195903 MD
Family Nurse Practitioner 363LF0000X R195903 MD
Psychiatric/Mental Health Nurse Practitioner 363LP0808X R195903 MD Primary

Addresses

Primary practice location

4630 Belair Rd Ste a
Baltimore, MD 21206-6354

Mailing address

4116 Villa Nova Rd
Pikesville, MD 21207-4651

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
I20231114003066 MD Practitioner - Nurse Practitioner 9335596295 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Conduit IncGroup PAC ID 4981073194, 3 clinicians

Practice addresses (Care Compare)

3901 Park Heights Ave
Baltimore, MD 21215-7013
Phone (443) 869-2680

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R195903MDMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Conduit Inc CurrentSince Sep 24, 2023 Accepting new patients
Conduit Inc CurrentSince Sep 24, 2023 Accepting new patients
Saving All Lives Matter, LLC CurrentSince Sep 1, 2020 Accepting new patients

Locations

3901 Park Heights Ave
Baltimore, MD 21215
Phone (443) 794-2253

4630 Belair Rd
Ste A
Baltimore, MD 21206
Phone (443) 253-0547

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": "1548720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728518400000",
    "number": "1821552282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4116 VILLA NOVA RD",
            "city": "PIKESVILLE",
            "state": "MD",
            "postal_code": "212074651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4630 BELAIR RD STE A",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212066354",
            "telephone_number": "443-990-1710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDOWELL",
        "first_name": "JENENE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-01-29",
        "last_updated": "2024-10-10",
        "certification_date": "2024-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MD",
            "license": "R195903",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R195903",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R195903",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.