Individual provider Active NPI

Wendy Jo Hannon, APRN,PMHNP-BC,ANP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Nottingham, MD
National Provider Identifier
1265404644
Registry record updated Jul 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
R133863 Issued in MD
Practice address
8009 Corporate Dr Unit C
Nottingham, MD 21236-4977
Phone
(410) 838-9500
NPI assigned
Feb 1, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X R133863 MD
Obstetrics & Gynecology Nurse Practitioner 363LX0001X R133863 MD
Psychiatric/Mental Health Nurse Practitioner 363LP0808X R133863 MD Primary

Addresses

Primary practice location

8009 Corporate Dr Unit C
Nottingham, MD 21236-4977

Mailing address

841 E Fort Ave # 366
Baltimore, MD 21230-5117

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
I20240731000755 MD Practitioner - Nurse Practitioner 8123565868 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Safe Harbor Behavioral Care LLCGroup PAC ID 0345514675, 81 clinicians

Practice addresses (Care Compare)

5430 Campbell Blvd
Suite 211
White Marsh, MD 21162-5504
Phone (410) 893-4600

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Safe Harbor Behavioral Care, LLC Psychiatric/Mental Health CurrentSince Jul 1, 2024 Accepting new patients
Safe Harbor Community Services Psychiatric/Mental Health PastSince Jun 1, 2023 Accepting new patients

Locations

606 Baltimore Ave
Ste 406
Baltimore, MD 21204

1208 E Churchville Rd
Ste 300
Bel Air, MD 21014
Phone (410) 838-9500

5430 Campbell Blvd
Ste 211
White Marsh, MD 21162
Phone (410) 838-9500

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1138752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720742400000",
    "number": "1265404644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "841 E FORT AVE # 366",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212305117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8009 CORPORATE DR UNIT C",
            "city": "NOTTINGHAM",
            "state": "MD",
            "postal_code": "212364977",
            "telephone_number": "410-838-9500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANNON",
        "first_name": "WENDY",
        "middle_name": "JO",
        "name_prefix": "Mrs.",
        "credential": "APRN,PMHNP-BC,ANP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-01",
        "last_updated": "2024-07-12",
        "certification_date": "2024-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MD",
            "license": "R133863",
            "primary": false
        },
        {
            "code": "363LX0001X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "MD",
            "license": "R133863",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R133863",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nottingham, MD

Sources for this page

Verify at the official NPI Registry.