Deepa Abhilash, CRNP
Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Salisbury, MD
NPI 1831718972 · NPPES record last updated Apr 10, 2024
Key facts
- NPI
- 1831718972
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- License
- R176640 (MD)
- Practice address
- 505 E Main St
Salisbury, MD 21804-5020 - Phone
- (410) 341-3420
- Fax
- (410) 341-3397
- NPI assigned
- Apr 9, 2020
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 11
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2021
- Medicare assignment
- May accept Medicare assignment
- Telehealth
- Offers telehealth services
- Group practices
- Project Chesapeake, LLC
Friends Behavioral Health Associates Inc
Practice addresses (Care Compare)
108 Old Solomons Island Rd
Suite a
Annapolis, MD 21401-0920
Phone (443) 440-5782
1300 S Division St
Suite a
Salisbury, MD 21804-6937
Phone (410) 219-3488
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MD
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200930003381 | MD | Practitioner - Nurse Practitioner | 7214356880 | Reassigns benefits to 4 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LG-0001421 | DE | MD | Family Nurse Practitioner |
| R176640 | MD | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Atlantic General Hospital Corporation | Nurse Practitioner | Current | Accepting new patients |
| Project Chesapeake, LLC | Current | Accepting new patients | |
| Atlantic General Hospital Corp | Current |
Accepting new patients | |
| Wicomico County Health Department | Current |
Accepting new patients | |
| Wicomico County Health Department | Current |
Accepting new patients | |
| Project Chesapeake, LLC | Current |
Accepting new patients | |
| Project Chesapeake, LLC | Current |
Accepting new patients | |
| Friends Behavioral Health Associates Inc | Psychiatric/Mental Health | Current |
Accepting new patients |
| Tidalhealth Atlantic, Inc. | Current |
Accepting new patients | |
| The Psychiatric Office of J Harkhani MD PC | Past |
Accepting new patients | |
| Atlantic Immedicare LLC | Past | Accepting new patients |
Locations
108 Old Solomons Island Rd
Ste A
Annapolis, MD 21401
Phone (410) 266-5054
185 Admiral Cochrane Dr
Ste 120
Annapolis, MD 21401
10026 Old Ocean City Blvd
Ste 1
Berlin, MD 21811
9714 Healthway Dr
Berlin, MD 21811
Phone (410) 641-2600
3680 Warwick Rd
East New Market, MD 21631
Phone (410) 943-8108
1300 S Division St
Ste A
Salisbury, MD 21804
Phone (410) 219-3488
108 E Main St
Salisbury, MD 21801
Phone (410) 334-3497
6040 Public Landing Rd
Snow Hill, MD 21863
Phone (410) 629-0041
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | LG-0001421 | DE | |
| Family Nurse Practitioner | 363LF0000X | LG-0001421 | DE | |
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | R176640 | MD | Yes |
Addresses
Primary practice location
505 E Main St
Salisbury, MD 21804-5020
Mailing address
8558 Shadow LN
Delmar, MD 21875-2562
Phone (516) 263-4729
Other practice location 1
10252 Stone Creek Dr
Laurel, DE 19956-4702
Phone (302) 251-8870
Other practice location 2
30668 Sussex Hwy
Laurel, DE 19956-4421
Phone (302) 251-8870
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| LG-0001421 | Other | DE | FAMILY NURSE PREACTIONER LICENSE NO: |
| R176640 | Other | MD | CRNP-PMH LICENSE |
Other names
- Mrs. Deepa Gopalakrishnan
Other providers in Salisbury, MD
- A Plus Medical PC
- A Touch of Love Home Care LLC
- Trevor Abbott
- Frishta Abdul Ali
- Matthew Dean Abell
- Ability Rehab Associates
- Ability Rehab Associates
- Ability Rehab Associates
- Zeinab Abou Yehia
- Catherine Patricia Abrams
All providers in Salisbury, MD · Psychiatric/Mental Health Nurse Practitioner in Maryland
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 10, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.