Individual provider Active NPI

Richard Hanna

  • Psychiatric/Mental Health Nurse Practitioner
  • Baltimore, MD
National Provider Identifier
1124993704
Registry record updated Oct 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
R238580 Issued in MD
Practice address
2500 W Forest Park Ave
Baltimore, MD 21215-7913
Phone
(443) 844-7833
NPI assigned
Oct 6, 2025
Last updated
Oct 6, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 6, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X R238580 MD Primary

Addresses

Primary practice location

2500 W Forest Park Ave
Baltimore, MD 21215-7913

Mailing address

2500 W Forest Park Ave
Baltimore, MD 21215-7913
Phone (443) 844-7833

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
I20260203001129 MD Practitioner - Nurse Practitioner 3870071582 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2500 W Forest Park Ave
Baltimore, MD 21215-7913

2901 Druid Park Dr
Suite A202
Baltimore, MD 21215-8178

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R238580MDMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Parkway Mental Health and Wellness Psychiatric/Mental Health CurrentSince Jun 27, 2026 Accepting new patients
Victorious Mental Healthcare LLC CurrentSince Jan 1, 2026 Accepting new patients
Victorious Mental Healthcare LLC CurrentSince Jan 1, 2026 Accepting new patients

Locations

2901 Druid Park Dr
Ste A202
Baltimore, MD 21215
Phone (410) 225-0062

1777 Reisterstown Rd
Ste 268
Pikesville, MD 21208
Phone (410) 653-7353

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1759708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759708800000",
    "number": "1124993704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 W FOREST PARK AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212157913",
            "telephone_number": "443-844-7833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 W FOREST PARK AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212157913",
            "telephone_number": "443-844-7833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANNA",
        "first_name": "RICHARD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-10-06",
        "last_updated": "2025-10-06",
        "certification_date": "2025-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R238580",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.