Sandra Kelley Wieland, CRNP-PMH

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

R038366 Issued in MD

Practice address

813 Chesapeake Dr Ste 1
Cambridge, MD 21613-9405

Phone

(410) 221-2266

Fax

(410) 221-2878

NPI assigned

Jul 18, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Channel Marker, Inc.

  • Mental Health Counselor
  • Easton, MD
  • NPI 1164639209
  Medicare reassignment NPD
• For All Seasons, Inc

  • Clinical Social Worker
  • Easton, MD
  • NPI 1619087202
  NPD (past)
• For All Seasons, Inc.

  • Clinical Social Worker
  • Cambridge, MD
  • NPI 1871732693
  NPD (past)

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

{
    "created_epoch": "1184716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557705600000",
    "number": "1164622254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "813 CHESAPEAKE DR STE 1",
            "city": "CAMBRIDGE",
            "state": "MD",
            "postal_code": "216139405",
            "telephone_number": "410-221-2266",
            "fax_number": "410-221-2878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "813 CHESAPEAKE DR STE 1",
            "city": "CAMBRIDGE",
            "state": "MD",
            "postal_code": "216139405",
            "telephone_number": "410-221-2266",
            "fax_number": "410-221-2878"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16 Willis Ave",
            "address_purpose": "LOCATION",
            "city": "Easton",
            "state": "MD",
            "postal_code": "216013241",
            "country_code": "US",
            "telephone_number": "410-822-5540",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8865 Glebe Park Dr Unit 1",
            "address_purpose": "LOCATION",
            "city": "Easton",
            "state": "MD",
            "postal_code": "216017069",
            "country_code": "US",
            "telephone_number": "410-822-4611",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WIELAND",
        "first_name": "SANDRA",
        "middle_name": "KELLEY",
        "name_prefix": "Mrs.",
        "credential": "CRNP-PMH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-18",
        "last_updated": "2019-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "RO38366",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R038366",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "479302100",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "415081300",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kawana Laya Webb, LCSW-C
• Deborah Christopher Weber, LCPC, MA
• Kathleen M Whelton, DMD
• David Christopher White, MD
• Eric Joseph Widmaier, MD
• Ryan Michael Wilkinson, NREMT
• Carey Page Willey, O.D.
• Dell Marie Williams- Joyner, LPN
• Latrell Williams-Elliott, LC16135
• Barbara Reilly Williams, PT

• Psychiatric/Mental Health Nurse Practitioner in Cambridge, MD
• Providers in Cambridge, MD by specialty
• Psychiatric/Mental Health Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2019; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.