Individual provider Active NPI

Renada Lynn Gilliard, DNP, MS, CRNP

  • Adult Health Nurse Practitioner
  • Catonsville, MD
National Provider Identifier
1093581647
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
R111793 Issued in MD
Practice address
9 Turk Garth
Catonsville, MD 21228-2806
Phone
(443) 695-4433
NPI assigned
Nov 27, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X R111793 MD Primary

Addresses

Primary practice location

9 Turk Garth
Catonsville, MD 21228-2806

Mailing address

9 Turk Garth
Catonsville, MD 21228-2806
Phone (443) 695-4433

Other names 1

  • Renada Lynn Becketts Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240611000357 MD Practitioner - Nurse Practitioner 2668914292 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Greater Baltimore Medical CenterGroup PAC ID 1759276975, 350 clinicians

Practice addresses (Care Compare)

63 E Padonia Rd
Timonium, MD 21093-2306

6569 N Charles St
Baltimore, MD 21204-5816

Hospital & facility affiliations

  • Greater Baltimore Medical Center Hospital, Baltimore, MD, CCN 210044

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R111793MDMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Greater Baltimore Medical Center, Inc. CurrentSince May 12, 2024 Accepting new patients
Greater Baltimore Medical Center, Inc Current Accepting new patients
Greater Baltimore Medical Center, Inc. CurrentSince May 12, 2024 Accepting new patients

Locations

6569 N Charles St
Ste 505
Towson, MD 21204
Phone (443) 849-2196

6569 N Charles St
Ste 307
Towson, MD 21204
Phone (443) 849-2767

Organizations & group practices 3

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1701043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1093581647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 TURK GARTH",
            "city": "CATONSVILLE",
            "state": "MD",
            "postal_code": "212282806",
            "telephone_number": "443-695-4433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 TURK GARTH",
            "city": "CATONSVILLE",
            "state": "MD",
            "postal_code": "212282806",
            "telephone_number": "443-695-4433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLIARD",
        "first_name": "RENADA",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "DNP, MS, CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-27",
        "last_updated": "2023-11-27",
        "certification_date": "2023-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MD",
            "license": "R111793",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RENADA",
            "last_name": "BECKETTS",
            "middle_name": "LYNN",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Catonsville, MD

Sources for this page

Verify at the official NPI Registry.