Individual provider Active NPI

Mandy Cranney, NP

  • Gerontology Nurse Practitioner
  • Waldoboro, ME
National Provider Identifier
1104443803
Registry record updated May 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
CNP211052 Issued in ME
Practice address
27 Mill St
Waldoboro, ME 04572-6013
Phone
(207) 832-2300
NPI assigned
Jun 29, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Medical-Surgical Registered Nurse 163WM0705X RN73938 ME
Adult Health Nurse Practitioner 363LA2200X CNP211052 ME
Primary Care Nurse Practitioner 363LP2300X CNP211052 ME
Gerontology Nurse Practitioner 363LG0600X CNP211052 ME Primary

Addresses

Primary practice location

27 Mill St
Waldoboro, ME 04572-6013

Mailing address

51 Elm St
Camden, ME 04843-1910
Phone (207) 230-9259

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
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
I20221110000611 ME Practitioner - Nurse Practitioner 6305213927 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mainehealth 2,616 clinicians

Practice addresses (Care Compare)

22 Bramhall St
Portland, ME 04102-3134
Phone (207) 885-9905

30 Community Dr
Camden, ME 04843-2061
Phone (207) 921-6100

Hospital & facility affiliations

  • Mainehealth Home Health and Hospice Home health agency, Saco, ME, CCN 207000
  • Mainehealth Home Health and Hospice Hospice, Rockport, ME, CCN 201508
  • Mainehealth Pen Bay Hospital Hospital, Rockport, ME, CCN 200063
  • Lincolnhealth Hospital, Damariscotta, ME, CCN 201302

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN73938MEMDMedical-Surgical Registered Nurse
CNP211052MEMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mainehealth CurrentSince Nov 28, 2022 Accepting new patients
Mainehealth Current Accepting new patients
Mainehealth CurrentSince Nov 28, 2022 Accepting new patients
Mainehealth Past Accepting new patients
Mainehealth Past Accepting new patients

Locations

22 Bramhall St
Portland, ME 04102
Phone (207) 662-2179

75 Maverick St
Ste 1
Rockland, ME 04841

27 Mill St
Waldoboro, ME 04572
Phone (207) 832-2300

27 Mill St
Apt 1
Waldoboro, ME 04572

Interoperability endpoints

  • Direct secure messaging: mcranney560139@direct.mmc.mainehealth.org

Organizations & group practices 5

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 4

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": "1593388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715126400000",
    "number": "1104443803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51 ELM ST",
            "city": "CAMDEN",
            "state": "ME",
            "postal_code": "048431910",
            "telephone_number": "207-230-9259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27 MILL ST",
            "city": "WALDOBORO",
            "state": "ME",
            "postal_code": "045726013",
            "telephone_number": "207-832-2300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRANNEY",
        "first_name": "MANDY",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-29",
        "last_updated": "2024-05-08",
        "certification_date": "2024-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WM0705X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Medical-Surgical",
            "state": "ME",
            "license": "RN73938",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "ME",
            "license": "CNP211052",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "ME",
            "license": "CNP211052",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "ME",
            "license": "CNP211052",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waldoboro, ME

Sources for this page

Verify at the official NPI Registry.