MRS. MARY ALICE S SHORES (NPI# 1922097161) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922097161 |
| Entity Type | Individual |
| Full Name | MRS. MARY ALICE S SHORES |
| Credential | CRNP |
| Practice Address |
1380 Progress Way Suite 114 Eldersburg MD 21784-6464 |
| Practice Telephone | 4107952233 |
| Practice Fax Number | 4107953538 |
| Mailing Telephone | 4107952233 |
| Mailing Fax Number | 4107953538 |
| Enumeration Date | 2005-10-20 |
| Last Update Date | 2010-05-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | R124642 | MD | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MD | MEDICARE GROUP #-CARROLL PRIMARY CARE-124L | 124L | 01 |
| MD | STATE OF MD | R124642 | 01 |
| Street Address |
1380 PROGRESS WAY SUITE 114 |
| City | ELDERSBURG |
| State | MD |
| Zip Code | 21784-6464 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366818056 | Carroll County Ambulatory Surgical Center, LLC | Clinic/Center | 1380 Progress Way, Suite 114, Eldersburg, MD 21784-6464 | 2015-08-17 |
| 1922400720 | Mary L Udseth | Physician Assistant | 1380 Progress Way, Suite 114, Eldersburg, MD 21784-6464 | 2014-09-23 |
| 1003155870 | Sandra Lashley | Psychologist | 1380 Progress Way, Suite101, Eldersburg, MD 21784-6464 | 2013-02-13 |
| 1144506403 | Jacquelyn Lee Welch | Physical Therapist | 1380 Progress Way, Eldersburg, MD 21784-6464 | 2011-10-31 |
| 1871878785 | Pamela Hain-koenigsburg | Psychologist | 1380 Progress Way, Ste 101, Eldersburg, MD 21784-6464 | 2011-10-12 |
| 1407163439 | Donnell I James Jr. | Physician Assistant | 1380 Progress Way, Suite 112, Eldersburg, MD 21784-6464 | 2010-09-13 |
| 1548574445 | Holly A Kilby | Nurse Practitioner | 1380 Progress Way, Suite 102, Eldersburg, MD 21784-6464 | 2010-08-03 |
| 1518117761 | Carroll Counseling Center, LLC | Psychologist | 1380 Progress Way, Suite 101, Eldersburg, MD 21784-6464 | 2008-09-24 |
| 1417142290 | Connie Lynn Blizzard | Psychologist | 1380 Progress Way, #101, Eldersburg, MD 21784-6464 | 2007-09-13 |
| 1215120951 | Carrolltowne Medical Center P.a. | Family Medicine | 1380 Progress Way, Suite112, Eldersburg, MD 21784-6464 | 2007-08-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033681085 | Kathleen Busching | Occupational Therapy Assistant | Intergrace Fairhaven, 7200 Third Ave, Sykesville, MD 21784 | 2018-12-31 |
| 1619450376 | Mackenzie Fleming | Counselor | 6220 Georgetown Blvd Suite C, Eldersburg, MD 21784 | 2018-09-10 |
| 1316426919 | Rebecca Rubin | Nurse Practitioner | 1380 Progress Way, Suite 102, Eldersburg, MD 21784 | 2018-08-14 |
| 1417473273 | Andrey Doroshenko | Dentist | 1722 Underwood Road, Sykesville, MD 21784 | 2017-08-14 |
| 1992229694 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 6400 Georgetown Blvd, Eldersburg, MD 21784 | 2017-08-03 |
| 1457894495 | Bethany Six | Nurse Practitioner | 6190 Gerogetown Blvd, Eldersburg, MD 21784 | 2016-11-23 |
| 1982011821 | Fast Track Urgent Care, LLC | Clinic/Center | 1315 Breton Drive, Eldersburg, MD 21784 | 2014-07-11 |
| 1588097984 | Centers for Advanced Orthopaedics, LLC | Orthopaedic Surgery | 5961 Exchange Dr, Suite 100, Eldersburg, MD 21784 | 2013-08-21 |
| 1356690986 | Kayla Nicole Koster | Speech-Language Pathologist | 1702 Liberty Road, First Floor, Sykesville, MD 21784 | 2012-08-29 |
| 1558645663 | Fusion Dental | Dentist | 5959 Exchange Drive, Suite 116, Eldersburg, MD 21784 | 2011-10-07 |
| Find all providers in zip 21784 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457894495 | Bethany Six | Nurse Practitioner | 6190 Gerogetown Blvd, Eldersburg, MD 21784 | 2016-11-23 |
| 1356957534 | Megan Ryan-riffle | Nurse Practitioner | 6040 Sykesville Rd, Eldersburg, MD 21784-6000 | 2020-09-22 |
| 1649662776 | Genna Sellers | Nurse Practitioner | 6190 Georgetown Blvd, Eldersburg, MD 21784-6460 | 2015-02-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558961250 | Cassandra Jordan Holmes | Nurse Practitioner | 10 Center Drive Lcim Niaid Nih, Bethesda, MD 20892-0001 | 2020-10-30 |
| 1962000679 | Laly Sorto | Nurse Practitioner | 923 S Curley St, Baltimore, MD 21224-4825 | 2020-10-14 |
| 1841897139 | Ha Le | Nurse Practitioner | 160 Ritchie Hwy, Severna Park, MD 21146-1120 | 2020-10-08 |
| 1386241685 | Audrey Roxanne Mathew | Nurse Practitioner | 546 N Frederick Ave # 1490, Gaithersburg, MD 20877-2504 | 2020-10-08 |
| 1093312209 | Shelby Bruno | Nurse Practitioner | 29 S Greene St Fl 2, Baltimore, MD 21201-1504 | 2020-10-01 |
| 1295342772 | Gilead Associates LLC | Nurse Practitioner | 206 Mulberry Ridge Ct, Pasadena, MD 21122-7514 | 2020-09-28 |
| 1659986735 | Tatyana Vladimirovna Valentin | Nurse Practitioner | 490 Cadmus Ln Ste 102, Easton, MD 21601-4091 | 2020-09-15 |
| 1205440328 | Courtney Lavon Phillip | Nurse Practitioner | 4461 Pleasant Hill Ct, Pomfret, MD 20675-3104 | 2020-09-04 |
| 1386256634 | Steven Carroll | Nurse Practitioner | 731 Crisfield Way, Annapolis, MD 21401-4576 | 2020-08-18 |
| 1346850666 | Cynthia Adwoah Mireku-baabu | Nurse Practitioner | 19241 Sharon Dr, Hagerstown, MD 21742-2433 | 2020-08-01 |
| Find all providers with the same taxonomy | ||||
| City | ELDERSBURG |
| Zip Code | 21784 |
Please comment or provide details below to improve the information on MRS. MARY ALICE S SHORES.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.