Tracey Cunningham, CRNP-PMH
Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Baltimore, MD
NPI 1275942245 · NPPES record last updated Aug 4, 2014
Key facts
- NPI
- 1275942245
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- License
- R166906 (MD)
- Practice address
- 114 S Washington St
Baltimore, MD 21231-1937 - Phone
- (410) 255-1400
- NPI assigned
- Aug 4, 2014
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Psych Associates of Maryland LLC
Practice addresses (Care Compare)
120 Sister Pierre Dr
Suite 403
Towson, MD 21204-7536
Phone (410) 823-6408
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in MD, DC
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20140919001176 | MD | Practitioner - Nurse Practitioner | 8123247350 | Reassigns benefits to 1 organization |
| I20150306002173 | DC | Practitioner - Nurse Practitioner | 8123247350 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Psych Associates of Maryland LLC | Current |
Accepting new patients | |
| Kraus Behavioral Health LLC | Psychiatric/Mental Health | Past | Accepting new patients |
| Neta, Inc. | Past |
Accepting new patients |
Locations
4520 East West Hwy
Ste 775
Bethesda, MD 20814
Phone (240) 531-2799
9520 Berger Rd
Ste 203
Columbia, MD 21046
Phone (410) 290-6940
9715 Medical Center Dr
Ste 528
Rockville, MD 20850
Phone (301) 340-1355
2331 York Rd
Ste 100
Timonium, MD 21093
120 Sister Pierre Dr
Ste 403
Towson, MD 21204
7001 Johnnycake Rd
Ste 107
Windsor Mill, MD 21244
Phone (410) 255-1400
Interoperability endpoints
- bloomhealthcenters.traceycunningham@131200.advancedmd-direct.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | R166906 | MD | Yes |
Addresses
Primary practice location
114 S Washington St
Baltimore, MD 21231-1937
Mailing address
5132 Key View Way
Perry Hall, MD 21128-8938
Phone (410) 919-3503
Other providers in Baltimore, MD
- Patricia L Cunningham
- Patsy Cunningham
- Reginald Cunningham
- Steven Clark Cunningham
- Susan Kimberly Cunningham
- Wendy Cunningham
- Rachael Cupid
- Bryan J Cupka
- Deanna Colette Cupo
- Kathryn Lee Cupples
All providers in Baltimore, MD · Psychiatric/Mental Health Nurse Practitioner in Maryland
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 4, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.