MEDICARE: JOHNS HOPKINS UNIVERSITY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number State
1	152W00000X	Optometrist	MD
2	207WX0009X	Glaucoma Specialist (Ophthalmology) Physician
3	207WX0107X	Retina Specialist (Ophthalmology) Physician
4	207WX0108X	Uveitis and Ocular Inflammatory Disease (Ophthalmology) Physician
5	207WX0109X	Neuro-ophthalmology Physician
6	207WX0110X	Pediatric Ophthalmology and Strabismus Specialist Physician Physician
7	207WX0120X	Cornea and External Diseases Specialist Physician
8	207WX0200X	Ophthalmic Plastic and Reconstructive Surgery Physician
9	207W00000X	Ophthalmology Physician	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	CA9060	OTHER	MD	RRMC
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1588654289
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOHNS HOPKINS UNIVERSITY

Provider Business Mailing Address
First Line	:	6201 GREENLEIGH AVE
Second Line	:
City	:	MIDDLE RIVER
State	:	MD
Zip	:	21220-2004
Country	:	US
Telephone Number	:	410-933-6423
Fax Number	:	410-500-4266

Provider Business Practice Location Address
First Line	:	600 NORTH WOLFE STREET
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21264-0001
Country	:	US
Telephone Number	:	410-614-5115
Fax Number	:

Authorized Official
Title or Position	:	SR PRODUCTION UNIT MGR
Name	:	SHAVONDA L KEATING
Credential	:
Telephone Number	:	410-933-6430

Provider Enumeration Date	:	10/24/2005
Last Update Date	:	10/11/2022

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Directions to “JOHNS HOPKINS UNIVERSITY ” Practice Location

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