Mary Theresa Fanning, CRNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

SP018724 Issued in PA

Practice address

2350 Freedom Way Ste 200
York, PA 17402-8200

Phone

(717) 812-5120

NPI assigned

Jun 15, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA, 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

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St Agnes Healthcare IncGroup PAC ID 9830092733, 265 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Saint Agnes Hospital Hospital, Baltimore, MD, CCN 210011

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• St Agnes Healthcare Inc

  • Internal Medicine Physician
  • Baltimore, MD
  • NPI 1144250176
  Medicare reassignment Care Compare group NPD
• Wellspan Medical Group

  • Gastroenterology Physician
  • York, PA
  • NPI 1669770004
  Medicare reassignment NPD
• Chesapeake Digestive Associates, PC

  • Gastroenterology Physician
  • Annapolis, MD
  • NPI 1023765625
  Medicare reassignment NPD
• Digestive Disease Associates, LLC

  • Gastroenterology Physician
  • Baltimore, MD
  • NPI 1407400955
  Medicare reassignment NPD
• Wellspan Medical Group

  • Pediatric Surgery Physician
  • York, PA
  • NPI 1104799428
  NPD
• St Agnes Healthcare Inc

  • Diagnostic Radiology Physician
  • Baltimore, MD
  • NPI 1780615922
  NPD
• Wellspan Medical Group

  • Neurological Surgery Physician
  • Hagerstown, MD
  • NPI 1881279966
  NPD

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

• St. Agnes Healthcare, Inc.

  • General Acute Care Hospital
  • Baltimore, MD
  • NPI 1245274901
  Care Compare affiliation

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

{
    "created_epoch": "1529020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579824000000",
    "number": "1194219097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 CIRCLE DR",
            "city": "GLEN ROCK",
            "state": "PA",
            "postal_code": "173271341",
            "telephone_number": "717-701-6046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2350 FREEDOM WAY STE 200",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174028200",
            "telephone_number": "717-812-5120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FANNING",
        "first_name": "MARY",
        "middle_name": "THERESA",
        "name_prefix": "Miss",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-15",
        "last_updated": "2020-01-24",
        "certification_date": "2020-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP018724",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Family Health Apothecary
• Family Home Medical Supply Inc
• Family Medicine Associates of York, LLC
• Family-Child Resources Inc
• Olufunsho Oladele Famuyiwa, MD
• Andrew M Farabaugh, M.D.
• Melanie Rose Farabaugh, M.D.
• Donna Marie Faraone
• Linda T Farjo, CRNP
• Burhanuddin M Farooqi, MD

• Family Nurse Practitioner in York, PA
• Providers in York, PA by specialty
• Family Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2020; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.