Individual provider Active NPI

Jennifer Mellody Dukes, CRNP

  • Nurse Practitioner
  • Baltimore, MD
National Provider Identifier
1841568904
Registry record updated Dec 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
R132156 Issued in MD
Practice address
838 N Eutaw St
Baltimore, MD 21201-4624
Phone
(410) 523-1414
NPI assigned
Dec 5, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2011

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 R132156 MD Primary

Addresses

Primary practice location

838 N Eutaw St
Baltimore, MD 21201-4624

Mailing address

838 N Eutaw St
Baltimore, MD 21201-4624
Phone (410) 523-1414

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
I20140916000038 MD Practitioner - Nurse Practitioner 9537388012 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of Maryland Pediatric Associates, PA Current Accepting new patients
University of Maryland Pediatrics Assoc PA CurrentSince Apr 19, 2019 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

827 Linden Ave
Fl 2
Baltimore, MD 21201
Phone (443) 682-6800

22 S Greene St
#S6
Baltimore, MD 21201
Phone (667) 214-1916

22 S Greene St
#N5W40
Baltimore, MD 21201
Phone (410) 328-6749

22 S Greene St
Fl 5
Baltimore, MD 21201
Phone (410) 328-5887

627 Race St
Cambridge, MD 21613
Phone (410) 228-3223

12500 Willowbrook Rd
Cumberland, MD 21502
Phone (240) 964-1255

350 Montevue Ln
Frederick, MD 21702
Phone (301) 600-3102

7556 Teague Rd
Ste 420
Hanover, MD 21076
Phone (410) 328-6749

1639 Woodbrooke Dr
Salisbury, MD 21804
Phone (410) 543-7475

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": "1323043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323043200000",
    "number": "1841568904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "838 N EUTAW ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212014624",
            "telephone_number": "410-523-1414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "838 N EUTAW ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212014624",
            "telephone_number": "410-523-1414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUKES",
        "first_name": "JENNIFER",
        "middle_name": "MELLODY",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-12-05",
        "last_updated": "2011-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MD",
            "license": "R132156",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.