Individual provider Active NPI

Celicia Williams Little, CRNP

  • Pediatric Nurse Practitioner
  • Clinton, MD
National Provider Identifier
1871858464
Registry record updated Feb 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
R216132 Issued in MD
Practice address
9015 Woodyard Rd Ste 111
Clinton, MD 20735-4226
Phone
(301) 599-0900
Fax
(301) 599-7828
NPI assigned
Jul 10, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2019

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 9267954 FL
Pediatric Nurse Practitioner 363LP0200X R216132 MD Primary
Registered Nurse 163W00000X R216132 MD

Addresses

Primary practice location

9015 Woodyard Rd Ste 111
Clinton, MD 20735-4226

Mailing address

PO Box 744787
Atlanta, GA 30374-4787
Phone (301) 572-8734

Other practice location 1

600 N Wolfe St
CMSC 2-2116
Baltimore, MD 21287-0005
Phone (410) 955-8769

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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
I20220412000583 DC Practitioner - Nurse Practitioner 5395066864 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9267954FLMDRegistered Nurse
R216132MDMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Children'S Hospital CurrentSince Dec 14, 2021 Accepting new patients
Children'S Hospital Current Accepting new patients
Children'S Hospital CurrentSince Dec 14, 2021 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

111 Michigan Ave NW
Washington, DC 20010
Phone (202) 476-3670

600 N Wolfe St
#22116
Baltimore, MD 21287
Phone (410) 955-8769

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1341878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550188800000",
    "number": "1871858464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 744787",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303744787",
            "telephone_number": "301-572-8734",
            "fax_number": "301-681-0789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9015 WOODYARD RD STE 111",
            "city": "CLINTON",
            "state": "MD",
            "postal_code": "207354226",
            "telephone_number": "301-599-0900",
            "fax_number": "301-599-7828"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "600 N Wolfe St",
            "address_2": "CMSC 2-2116",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212870005",
            "country_code": "US",
            "telephone_number": "410-955-8769",
            "fax_number": "410-955-1464",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LITTLE",
        "first_name": "CELICIA",
        "middle_name": "WILLIAMS",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-10",
        "last_updated": "2019-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "9267954",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MD",
            "license": "R216132",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MD",
            "license": "R216132",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton, MD

Sources for this page

Verify at the official NPI Registry.