Individual provider Active NPI

Jaimie Ann Pierce Hedrick, PA-C

  • Physician Assistant
  • Baltimore, MD
National Provider Identifier
1902115942
Registry record updated Mar 14, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
C0004303 Issued in MD
Practice address
2200 Kernan Dr
Baltimore, MD 21207-6665
Phone
(410) 448-6418
NPI assigned
Sep 24, 2010
Last updated
Mar 14, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X C0004303 MD Primary

Addresses

Primary practice location

2200 Kernan Dr
Baltimore, MD 21207-6665

Mailing address

2200 Kernan Dr
Baltimore, MD 21207-6665
Phone (410) 448-6418

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
I20140521001547 MD Practitioner - Physician Assistant 6406079367 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
C0004303MDMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
St Agnes Healthcare Inc Physician Assistant CurrentSince Feb 26, 2014 Accepting new patients
Carroll Health Group, LLC CurrentSince Dec 5, 2016 Accepting new patients
St Agnes Healthcare Inc CurrentSince Feb 26, 2014 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

900 S Caton Ave
Baltimore, MD 21229
Phone (410) 368-3120

193 Stoner Ave
Ste 220
Westminster, MD 21157
Phone (410) 871-2204

Interoperability endpoints

  • Direct secure messaging: jpiercehendrick478834@direct.umm.edu

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": "1285286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489449600000",
    "number": "1902115942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 KERNAN DR",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212076665",
            "telephone_number": "410-448-6418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 KERNAN DR",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212076665",
            "telephone_number": "410-448-6418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIERCE HEDRICK",
        "first_name": "JAIMIE",
        "middle_name": "ANN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-24",
        "last_updated": "2017-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C0004303",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.