THE PRACTITIONER PROVIDER LLC
NPI 1083587562
Nurse Practitioner in Baltimore, MD

Q: What is The Practitioner Provider LLC's NPI number?

The NPI number for The Practitioner Provider LLC is 1083587562. It was assigned to this organization in the NPPES registry on September 29, 2025.

Q: What is The Practitioner Provider LLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Active since September 29, 2025CLIA 21D2348820 · Waiver

424 E 30TH ST, BALTIMORE, MD 21218(443) 609-4661(206) 752-6808 Get Directions Write a Review

NPPES record last updated: August 13, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Aug 13, 2026, Mar 9, 2026 (2 updates tracked since 2026).

On this page

About The Practitioner Provider Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

THE PRACTITIONER PROVIDER LLC (NPI 1083587562) is a healthcare organization registered as a nurse practitioner in Baltimore, Maryland and active in the NPI registry since September 2025. The organization holds a CLIA Waiver certificate valid through August 11, 2028 and lists Chloe J Parker, Owner, as its authorized official.

NPPES Registry Identity

NPI1083587562

Entity TypeOrganization

Primary Taxonomy363L00000X

Legal Business NameTHE PRACTITIONER PROVIDER LLC

Location Address424 E 30TH STBaltimore, MD 21218-3934

Mailing Address424 E 30th StBaltimore, MD 21218-3934 · (443) 609-4661 · Fax (206) 752-6808

Phone(443) 609-4661

Fax(206) 752-6808

Organization SubpartNo

Authorized OfficialChloe J ParkerOwner · (443) 609-4661

Enumeration DateSeptember 29, 2025

Last NPPES UpdateAugust 13, 20262 updates tracked since enumeration

NPPES CertifiedAugust 13, 2026

✔ NPI 1083587562 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363L00000X

Definition

(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.

424 E 30TH ST, Baltimore, MD 21218

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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

The Practitioner Provider Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to The Practitioner Provider LLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Chloe Parker, NP

Nurse Practitioner

NPI 1508251240

2434 W BELVEDERE AVE
Baltimore, MD 21215

(410) 548-2343

✔ PECOS✔ Accepts Medicare3.6 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 21D2348820

The Practitioner Provider LLC · Baltimore, MD

Active · expires Aug 11, 2028

CLIA Number21D2348820

Laboratory TypePhysician Office

Certificate Effective DateAugust 12, 2026

Certificate Expiration DateAugust 11, 2028

Laboratory DirectorChloe Parker

Laboratory Phone(443) 824-9331

Laboratory LocationThe Practitioner Provider LLC424 E 30th Street, Baltimore, MD 21218

CLIA data matches this NPI record on: Address Name

This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is The Practitioner Provider LLC's NPI number?

The NPI number for The Practitioner Provider LLC is 1083587562. It was assigned to this organization in the NPPES registry on September 29, 2025.

Where is The Practitioner Provider LLC located?

The Practitioner Provider LLC is located at 424 E 30th St, Baltimore, MD 21218. The listed phone number is (443) 609-4661.

What is The Practitioner Provider LLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Is The Practitioner Provider LLC enrolled in Medicare?

Yes. The Practitioner Provider LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through The Practitioner Provider LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to The Practitioner Provider LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does The Practitioner Provider LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 21D2348820) is associated with this NPI, valid through August 11, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for The Practitioner Provider LLC was last updated on August 13, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.