Individual provider Active NPI

Abigail Grace Stubblefield

  • Family Nurse Practitioner
  • Swan Point, MD
National Provider Identifier
1831871896
Registry record updated Sep 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AC005822 Issued in MD
Practice address
14745 Jennifer CT
Swan Point, MD 20645-2104
Phone
(678) 350-8083
NPI assigned
Aug 1, 2023
Last updated
Sep 1, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AC005822 MD Primary
Registered Nurse 163W00000X 291278 GA

Addresses

Primary practice location

14745 Jennifer CT
Swan Point, MD 20645-2104

Mailing address

14745 Jennifer CT
Swan Point, MD 20645-2104

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
291278GAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Medstar Urgent Care LLC CurrentSince Dec 31, 2023 Accepting new patients
Medstar Urgent Care, LLC Current Accepting new patients
Medstar Urgent Care LLC Current Accepting new patients
Medstar Urgent Care LLC CurrentSince Dec 31, 2023 Accepting new patients

Locations

3007 Tilden St NW
Ste 5N
Washington, DC 20008

6317 York Rd
Baltimore, MD 21212
Phone (443) 777-6890

3064 Waldorf Market Pl
Waldorf, MD 20603
Phone (301) 932-5960

11915 Georgia Ave
Wheaton, MD 20902
Phone (301) 942-4505

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1690848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693526400000",
    "number": "1831871896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14745 JENNIFER CT",
            "city": "SWAN POINT",
            "state": "MD",
            "postal_code": "206452104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14745 JENNIFER CT",
            "city": "SWAN POINT",
            "state": "MD",
            "postal_code": "206452104",
            "telephone_number": "678-350-8083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STUBBLEFIELD",
        "first_name": "ABIGAIL",
        "middle_name": "GRACE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-01",
        "last_updated": "2023-09-01",
        "certification_date": "2023-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "AC005822",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "GA",
            "license": "291278",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Swan Point, MD

Sources for this page

Verify at the official NPI Registry.