Individual provider Active NPI

Pamela Jean Eaton, CRNP-A MSN

  • Adult Health Nurse Practitioner
  • Monrovia, MD
National Provider Identifier
1922005875
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
R050640 Issued in MD
Practice address
4202 Green Valley Road
Monrovia, MD 21770
Phone
(301) 865-4484
Fax
(240) 720-0360
NPI assigned
Jul 7, 2005
Last updated
Mar 7, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X R050640 MD Primary

Addresses

Primary practice location

4202 Green Valley Road
Monrovia, MD 21770

Mailing address

4202 Green Valley Road
Monrovia, MD 21770
Phone (301) 865-4484

Other identifiers 2

IdentifierTypeStateIssuer
R050640OtherMDNURSE PRACTITIONER
4043448-00MedicaidMD

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
I20120118000056 MD Practitioner - Nurse Practitioner 8426156605 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4202 Green Valley Rd
Monrovia, MD 21770-9517
Phone (301) 865-4484

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R050640MDMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Caring Hands of Fredrick, LLC Adult Health CurrentSince Sep 1, 2002 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

4202 Green Valley Rd
Monrovia, MD 21770
Phone (301) 865-4484

Organizations & group practices 2

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1120694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1922005875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4202 GREEN VALLEY ROAD",
            "city": "MONROVIA",
            "state": "MD",
            "postal_code": "21770",
            "telephone_number": "301-865-4484",
            "fax_number": "240-720-0360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4202 GREEN VALLEY ROAD",
            "city": "MONROVIA",
            "state": "MD",
            "postal_code": "21770",
            "telephone_number": "301-865-4484",
            "fax_number": "240-720-0360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EATON",
        "first_name": "PAMELA",
        "middle_name": "JEAN",
        "credential": "CRNP-A MSN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-07-07",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MD",
            "license": "R050640",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NURSE PRACTITIONER",
            "identifier": "R050640",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4043448-00",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Monrovia, MD

Sources for this page

Verify at the official NPI Registry.