Individual provider Active NPI

Shayla Mari Hemingway, NP

  • Family Nurse Practitioner
  • Waldorf, MD
National Provider Identifier
1881449650
Registry record updated Apr 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R234528 Issued in MD
Practice address
102 Paul Mellon CT Ste 102
Waldorf, MD 20602-2793
Phone
(301) 645-7414
NPI assigned
Apr 23, 2024
Last updated
Apr 23, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R234528 MD Primary

Addresses

Primary practice location

102 Paul Mellon CT Ste 102
Waldorf, MD 20602-2793

Mailing address

102 Paul Mellon CT Ste 102
Waldorf, MD 20602-2793
Phone (301) 645-7414

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
I20240528002830 MD Practitioner - Nurse Practitioner 0042652604 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ashvin J. Patel, M.D. PAGroup PAC ID 8022292374, 2 clinicians

Practice addresses (Care Compare)

102 Paul Mellon CT
Suite 102
Waldorf, MD 20602-2793
Phone (301) 645-7414

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R234528MDMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ashvin J. Patel, M.D. PA CurrentSince May 20, 2024 Accepting new patients

Locations

102 Paul Mellon Ct
Ste 102
Waldorf, MD 20602
Phone (301) 645-7414

Organizations & group practices 1

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": "1713830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713830400000",
    "number": "1881449650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 PAUL MELLON CT STE 102",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206022793",
            "telephone_number": "301-645-7414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 PAUL MELLON CT STE 102",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206022793",
            "telephone_number": "301-645-7414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEMINGWAY",
        "first_name": "SHAYLA",
        "middle_name": "MARI",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-04-23",
        "last_updated": "2024-04-23",
        "certification_date": "2024-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R234528",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waldorf, MD

Sources for this page

Verify at the official NPI Registry.