Individual provider Active NPI

Carrington R Wendell, PHD

  • Clinical Neuropsychologist
  • Severna Park, MD
National Provider Identifier
1295001014
Registry record updated Feb 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
Practice address
645 Baltimore Annapolis Blvd Ste 220
Severna Park, MD 21146
Phone
(410) 975-5058
NPI assigned
Mar 26, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X Primary

Addresses

Primary practice location

645 Baltimore Annapolis Blvd Ste 220
Severna Park, MD 21146

Mailing address

645 Baltimore Annapolis Blvd Ste 220
Severna Park, MD 21146-3934
Phone (410) 975-5058

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151028001540 MD Practitioner - Clinical Psychologist 1254640451 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

645 Baltimore Annapolis Blvd
Suite 220
Severna Park, MD 21146-3934
Phone (410) 975-5058

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
05406MDMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Chesapeake Neuropsychology, LLC Clinical Neuropsychologist CurrentSince Nov 1, 2017 Accepting new patients

Locations

2 Evergreen Rd
Ste 3
Severna Park, MD 21146
Phone (410) 975-5058

645 Baltimore Annapolis Blvd
Ste 220
Severna Park, MD 21146
Phone (410) 975-5058

Organizations & group practices 1

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": "1332720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580947200000",
    "number": "1295001014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "645 BALTIMORE ANNAPOLIS BLVD STE 220",
            "city": "SEVERNA PARK",
            "state": "MD",
            "postal_code": "211463934",
            "telephone_number": "410-975-5058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "645 BALTIMORE ANNAPOLIS BLVD STE 220",
            "city": "SEVERNA PARK",
            "state": "MD",
            "postal_code": "21146",
            "telephone_number": "410-975-5058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WENDELL",
        "first_name": "CARRINGTON",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-26",
        "last_updated": "2020-02-06",
        "certification_date": "2020-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Severna Park, MD

Sources for this page

Verify at the official NPI Registry.