Individual provider Active NPI

Sarah Anne Park, CRNP FAMILY

  • Family Nurse Practitioner
  • Frederick, MD
National Provider Identifier
1902252620
Registry record updated Aug 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R168207 Issued in MD
Practice address
610 Solarex CT
Frederick, MD 21703-8624
Phone
(301) 682-5500
Fax
(301) 663-8557
NPI assigned
May 12, 2016
Last updated
Aug 2, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2016

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 R168207 MD Primary

Addresses

Primary practice location

610 Solarex CT
Frederick, MD 21703-8624

Mailing address

6708 Accipiter Dr
New Market, MD 21774-2933
Phone (240) 629-8065

Other identifiers 1

IdentifierTypeStateIssuer
926580505MedicaidMD

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
I20161025000083 MD Practitioner - Nurse Practitioner 3476831561 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Meritus Medical Center IncGroup PAC ID 7113811795, shared by 8 NPIs, 730 clinicians

Practice addresses (Care Compare)

11110 Medical Campus Rd
Hagerstown, MD 21742-6700

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group, LLC CurrentSince Dec 3, 2016 Accepting new patients
Privia Medical Group, LLC CurrentSince Dec 3, 2016 Accepting new patients
Accessability Medcare LLC Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

133 Defense Hwy
Ste 112
Annapolis, MD 21401
Phone (410) 573-0140

610 Solarex Ct
Frederick, MD 21703
Phone (301) 663-6162

610 Solarex Ct
#2
Frederick, MD 21703

11350 Pembrooke Sq
Ste 304
Waldorf, MD 20603
Phone (301) 856-2810

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": "1463011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470096000000",
    "number": "1902252620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6708 ACCIPITER DR",
            "city": "NEW MARKET",
            "state": "MD",
            "postal_code": "217742933",
            "telephone_number": "240-629-8065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 SOLAREX CT",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217038624",
            "telephone_number": "301-682-5500",
            "fax_number": "301-663-8557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "SARAH",
        "middle_name": "ANNE",
        "credential": "CRNP FAMILY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-12",
        "last_updated": "2016-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R168207",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "926580505",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Frederick, MD

Sources for this page

Verify at the official NPI Registry.