Individual provider Active NPI

Tia McCray, NP

  • Women's Health Nurse Practitioner
  • Columbia, MD
National Provider Identifier
1104225135
Registry record updated Jul 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
R172203 Issued in MD
Practice address
5500 Knoll North Dr Ste 310
Columbia, MD 21045-2363
Phone
(240) 747-7785
Fax
(833) 359-1348
NPI assigned
Aug 14, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X R172203 MD Primary

Addresses

Primary practice location

5500 Knoll North Dr Ste 310
Columbia, MD 21045-2363

Mailing address

1627 Parkridge Cir Apt 125
Crofton, MD 21114-2808
Phone (301) 512-6429

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, MD2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20160322001685 DC Practitioner - Nurse Practitioner 3870890676 Reassigns benefits to 1 organization
I20160322001856 MD Practitioner - Nurse Practitioner 3870890676 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Luminis Health Medical Group, LLCGroup PAC ID 2860447315, 540 clinicians

Practice addresses (Care Compare)

2000 Medical Pkwy
Annapolis, MD 21401-3745

2000 Medical Pkwy
Suite 510
Annapolis, MD 21401-3747
Phone (443) 481-6659

2003 Medical Pkwy
Annapolis, MD 21401-3081

2003 Medical Pkwy Wayson Pavillion
Advanced Internal Medicine Residenc
Annapolis, MD 21401-3081
Phone (443) 951-4286

4175 N Hanson CT
209 Premier OB/GYN
Bowie, MD 20716-3184
Phone (301) 352-4007

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Luminis Health Medical Group, LLC CurrentSince Feb 16, 2016 Accepting new patients
Luminis Health Medical Group, LLC CurrentSince Feb 16, 2016 Accepting new patients
Luminis Health Medical Group, LLC CurrentSince Feb 16, 2016 Accepting new patients
Luminis Health Medical Group, LLC Current Accepting new patients
Luminis Health Medical Group, LLC Current Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

201 Defense Hwy
Ste 100
Annapolis, MD 21401
Phone (443) 481-6549

2003 Medical Pkwy
Ste 301
Annapolis, MD 21401
Phone (443) 481-3366

4175 N Hanson Ct
Ste 209
Bowie, MD 20716
Phone (301) 352-4007

4175 N Hanson Ct
Ste 201
Bowie, MD 20716
Phone (443) 481-1199

Interoperability endpoints

  • Direct secure messaging: tmccray37975@direct.aahs.org

Organizations & group practices 6

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 2

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": "1407974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690156800000",
    "number": "1104225135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1627 PARKRIDGE CIR APT 125",
            "city": "CROFTON",
            "state": "MD",
            "postal_code": "211142808",
            "telephone_number": "301-512-6429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5500 KNOLL NORTH DR STE 310",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210452363",
            "telephone_number": "240-747-7785",
            "fax_number": "833-359-1348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCRAY",
        "first_name": "TIA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-14",
        "last_updated": "2023-07-24",
        "certification_date": "2023-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "MD",
            "license": "R172203",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MD

Sources for this page

Verify at the official NPI Registry.