Nichole Lynn Pelletier, CRNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R162889 Issued in MD

Practice address

23415 Three Notch Rd
Suite 2054 Wildwood Center
California, MD 20619-4017

Phone

(301) 737-7833

Fax

(301) 737-4865

NPI assigned

Nov 2, 2006

Last updated

Nov 10, 2010By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Miss Nichole Lynn Brown Former name

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

Specialty

Nurse Practitioner

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Benner Medical Group PAGroup PAC ID 9537186952, 4 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Medstar Health Home Care Home health agency, Hyattsville, MD, CCN 217150
• Medstar Saint Mary's Hospital Hospital, Leonardtown, MD, CCN 210028

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse, Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Benner Medical Group PA

  • Internal Medicine Physician
  • Solomons, MD
  • NPI 1407970809

  Family

  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Medstar Health Visiting Nurse Association, Inc.

  dba MedStar Health Home Care

  • Home Health Agency
  • Greenbelt, MD
  • NPI 1154437879
  Care Compare affiliation
• St Marys Hospital of St Marys County Inc

  dba MedStar St. Mary's Hospital

  • General Acute Care Hospital
  • Leonardtown, MD
  • NPI 1780650473
  Care Compare affiliation

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

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1289347200000",
    "number": "1841379781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 189",
            "city": "HOLLYWOOD",
            "state": "MD",
            "postal_code": "206360189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23415 THREE NOTCH RD",
            "address_2": "SUITE 2054 WILDWOOD CENTER",
            "city": "CALIFORNIA",
            "state": "MD",
            "postal_code": "206194017",
            "telephone_number": "301-737-7833",
            "fax_number": "301-737-4865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELLETIER",
        "first_name": "NICHOLE",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-02",
        "last_updated": "2010-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R162889",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICHOLE",
            "last_name": "BROWN",
            "middle_name": "LYNN",
            "prefix": "MISS",
            "credential": "CRNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Katlyn Palmieri
• Candice S Parmer, LCSW-C
• Alyssa Parra
• Maunank Manharbhai Patel, M.D
• Pax Dental Pasadena, LLC (Sleep Plus Health)
• Debbie E Perez
• Michael Edward Perraut, M.D.
• Renee Perry
• Personalized Therapy, LLC
• Personalized Therapy, LLC

• Family Nurse Practitioner in California, MD
• Providers in California, MD by specialty
• Family Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.