Active NPI
Comprehensive Neurology and Sleep Medicine, P.a.
- Neurology Physician
- Frederick, MD
National Provider Identifier
1972509362
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurology Physician
- License
- D0035322
- Legal business name
- COMPREHENSIVE NEUROLOGY AND SLEEP MEDICINE, P.A.
- Practice address
- 172 Thomas Johnson Dr
Ste 100
Frederick, MD 21702-4405 - Phone
- (301) 694-0900
- Fax
- (301) 694-0657
- NPI assigned
- Jun 22, 2005
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Willa Shriver
- Title
- Practice Manager
- Phone
- (301) 694-0900
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurology Physician | 2084N0400X | D0035322 | MD | Primary |
Addresses
Primary practice location
172 Thomas Johnson Dr
Ste 100
Frederick, MD 21702-4405
Mailing address
172 Thomas Johnson Dr
Ste 100
Frederick, MD 21702-4405
Phone (301) 694-0900
Other identifiers 14
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 372721 | Other | VA | MAMSI/MDIPA/OC DME |
| 5113 | Other | DC | BLUE CROSS BLUE SHEILD |
| 613465 | Other | MD | MAMSI/MDIPA/OPT.CHOICE |
| KFE9CO | Other | MD | BLUE CROSS BLUE SHIELD |
| 3327089 | Other | MD | AETNA HMO |
| 3473625 | Other | VA | ATENA HMO |
| 372721 | Other | ME | MAMSI/MDIPA/OC DME |
| 4137505 | Other | MD | AETNA PPO/MC/EPO |
| 495169 | Other | MD | NCPPO |
| 526711100 | Medicaid | MD | |
| 1306711010 | Other | MD | CIGNA |
| 237074 | Other | VA | ANTHEM HEALTHKEEPERS |
| 500310 | Other | MD | UNITED HEALTHCARE |
| 237076 | Other | VA | ANTHEM BC/BS |
Other names 1
- Konrad W. Bakker, M.D., P.A.
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MD
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
3289 Woodburn Rd
#360
Annandale, VA 22003
Phone (703) 876-9870
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Sleep Medicine (Psychiatry & Neurology) Physician
- Frederick, MD
- NPI 1346246782
-
- Medical Physician Assistant
- Frederick, MD
- NPI 1295813319
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1119398400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1336003200000",
"number": "1972509362",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "172 THOMAS JOHNSON DR",
"address_2": "STE 100",
"city": "FREDERICK",
"state": "MD",
"postal_code": "217024405",
"telephone_number": "301-694-0900",
"fax_number": "301-694-0657"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "172 THOMAS JOHNSON DR",
"address_2": "STE 100",
"city": "FREDERICK",
"state": "MD",
"postal_code": "217024405",
"telephone_number": "301-694-0900",
"fax_number": "301-694-0657"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "COMPREHENSIVE NEUROLOGY AND SLEEP MEDICINE, P.A.",
"organizational_subpart": "NO",
"enumeration_date": "2005-06-22",
"last_updated": "2012-05-03",
"status": "A",
"authorized_official_last_name": "SHRIVER",
"authorized_official_first_name": "WILLA",
"authorized_official_title_or_position": "PRACTICE MANAGER",
"authorized_official_telephone_number": "301-694-0900"
},
"taxonomies": [
{
"code": "2084N0400X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychiatry & Neurology, Neurology",
"state": "MD",
"license": "D0035322",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAMSI/MDIPA/OC DME",
"identifier": "372721",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHEILD",
"identifier": "5113",
"state": "DC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAMSI/MDIPA/OPT.CHOICE",
"identifier": "613465",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "KFE9CO",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA HMO",
"identifier": "3327089",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ATENA HMO",
"identifier": "3473625",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAMSI/MDIPA/OC DME",
"identifier": "372721",
"state": "ME"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA PPO/MC/EPO",
"identifier": "4137505",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NCPPO",
"identifier": "495169",
"state": "MD"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "526711100",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "1306711010",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM HEALTHKEEPERS",
"identifier": "237074",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE",
"identifier": "500310",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BC/BS",
"identifier": "237076",
"state": "VA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Konrad W. Bakker, M.D., P.A.",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Frederick, MD
- Community Radiology Associates Inc
- Community Radiology Associates Inc
- Community Radiology Associates Inc
- Complete Chiropractic, P.C.
- Complete Wellness Pharmacy LLC
- Comprehensive Neurology Services, P.a.
- Comprehensive Neurology Services, P.a.
- Comprehensive Neuropsych Services
- Comprehensive Primary Care and Associates, LLC
- Comprehensive Rehab Consultants PLLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.