Individual provider Active NPI

William James Raynor III, AGPCNP-BC

  • Gerontology Nurse Practitioner
  • Cresaptown, MD
National Provider Identifier
1194680322
Registry record updated Dec 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
R232944 Issued in MD
Practice address
PO Box 5495
Cresaptown, MD 21505-5495
Phone
(301) 697-9199
NPI assigned
Dec 19, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X R232944 MD Primary

Addresses

Primary practice location

PO Box 5495
Cresaptown, MD 21505-5495

Mailing address

PO Box 5495
Cresaptown, MD 21505-5495
Phone (301) 697-9199

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
R232944MDMDGerontology Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1766102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766102400000",
    "number": "1194680322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5495",
            "city": "CRESAPTOWN",
            "state": "MD",
            "postal_code": "215055495",
            "telephone_number": "301-697-9199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PO BOX 5495",
            "city": "CRESAPTOWN",
            "state": "MD",
            "postal_code": "215055495",
            "telephone_number": "301-697-9199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAYNOR",
        "first_name": "WILLIAM",
        "middle_name": "JAMES",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "credential": "AGPCNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-12-19",
        "last_updated": "2025-12-19",
        "certification_date": "2025-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MD",
            "license": "R232944",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cresaptown, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.