Individual provider Active NPI

Judith Andrea Anderson, C.R.N.P.

  • Pediatric Nurse Practitioner
  • Baltimore, MD
National Provider Identifier
1992138648
Registry record updated Jul 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
R191504 Issued in MD
Practice address
345 Saint Paul St
Baltimore, MD 21202-2123
Phone
(410) 332-9000
NPI assigned
Aug 16, 2013
Last updated
Jul 27, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X R191504 MD Primary

Addresses

Primary practice location

345 Saint Paul St
Baltimore, MD 21202-2123

Mailing address

740 Mallard Dr
Deale, MD 20751-2200
Phone (301) 758-1227

Other practice location 1

1001 Pine Heights Ave
Suite 202
Baltimore, MD 21229-5208
Phone (410) 646-4009

Other names 1

  • Ms. Judith Andrea Holt Former name

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
I20140508001838 MD Practitioner - Nurse Practitioner 7810120243 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Sinai Hospital of Baltimore Inc Current Accepting new patients
Sinai Hospital of Baltimore Inc CurrentSince Sep 23, 2024 Accepting new patients
Sinai Hospital of Baltimore, Inc. CurrentSince Sep 23, 2024 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

2411 W Belvedere Ave
Ste 205
Baltimore, MD 21215
Phone (410) 601-8331

2435 W Belvedere Ave
Baltimore, MD 21215
Phone (410) 601-0900

Interoperability endpoints

  • Direct secure messaging: janderson92963@direct.mdmercy.com

Organizations & group practices 5

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": "1376611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658880000000",
    "number": "1992138648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "740 MALLARD DR",
            "city": "DEALE",
            "state": "MD",
            "postal_code": "207512200",
            "telephone_number": "301-758-1227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "345 SAINT PAUL ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212022123",
            "telephone_number": "410-332-9000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1001 Pine Heights Ave",
            "address_2": "Suite 202",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212295208",
            "country_code": "US",
            "telephone_number": "410-646-4009",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "JUDITH",
        "middle_name": "ANDREA",
        "name_prefix": "Mrs.",
        "credential": "C.R.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-16",
        "last_updated": "2022-07-27",
        "certification_date": "2022-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MD",
            "license": "R191504",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JUDITH",
            "last_name": "HOLT",
            "middle_name": "ANDREA",
            "prefix": "MS.",
            "credential": "C.R.N.P.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.