Kevin Richard Gormley, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

05041 Issued in MD

Practice address

30 Greenway St NW Ste 5
Glen Burnie, MD 21061-3557

Phone

(410) 760-9079

Fax

(410) 760-1121

NPI assigned

Apr 26, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Oasis the Mental Health Center LLCGroup PAC ID 8527424837, 26 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Oasis the Mental Health Center, LLC

  dba Oasis Behavioral Health Urgent Care

  • Psychiatry Physician
  • Glen Burnie, MD
  • NPI 1174606057
  Medicare reassignment Care Compare group NPD
• Greater Baltimore Counseling Center, LLC

  • Clinical Psychologist
  • Glen Burnie, MD
  • NPI 1376616938
  Medicare reassignment NPD
• Oasis the Mental Health Center, LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Annapolis, MD
  • NPI 1467309138

  Clinical

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1366934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1513036800000",
    "number": "1033553565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 GREENWAY ST NW STE 5",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210613557",
            "telephone_number": "410-760-9079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 GREENWAY ST NW STE 5",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210613557",
            "telephone_number": "410-760-9079",
            "fax_number": "410-760-1121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORMLEY",
        "first_name": "KEVIN",
        "middle_name": "RICHARD",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-26",
        "last_updated": "2017-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MD",
            "license": "05041",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gopher Wood Corp (Maxcare Pharmacy)
• Gopher Wood Corp (Maxcare Pharmacy LTC)
• Gopher Wood Corp (Maxcare Pharmacy)
• Elliott Gorbaty, M.D.
• Ineta Maria Gordon, LMT
• Lenita Naomi Gorrell, M.D.
• Darryl Gotwalt
• Bharathi Gowda, MD
• Grace Home Medical Equipment LLC (Home MediService Inc)
• Grace House Iop, LLC

• Clinical Psychologist in Glen Burnie, MD
• Providers in Glen Burnie, MD by specialty
• Clinical Psychologist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.