1538480975 NPI number — MR. CHRISTOPHER J RANKIN CRNP

Table of content: MR. CHRISTOPHER J RANKIN CRNP (NPI 1538480975)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1538480975 NPI number — MR. CHRISTOPHER J RANKIN CRNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RANKIN
Provider First Name:
CHRISTOPHER
Provider Middle Name:
J
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
CRNP
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1538480975
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/18/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 37174
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BALTIMORE
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21297-3174
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
571-423-5699
Provider Business Mailing Address Fax Number:
571-423-5698

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
44045 RIVERSIDE PKWY STE 100
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LEESBURG
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
20176-5101
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
703-858-8878
Provider Business Practice Location Address Fax Number:
703-858-8170
Provider Enumeration Date:
06/21/2010

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208M00000X , with the licence number:  R172720 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363L00000X , with the licence number: 0024169123 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 6423316 . This is a "AETNA HMO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 321110000 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
  • Identifier: 9391588 . This is a "AETNA PPO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 607156012 . This is a "FEDERAL WORKMAN'S COMP (DEPT OF LABOR)" identifier . This identifiers is of the category "OTHER".
  • Identifier: 145724700 . This is a "FEDERAL WORKMAN'S COMP/DEPT. OF LABOR" identifier . This identifiers is of the category "OTHER".




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