Individual provider Active NPI

Ashley Nicole McKenzie, CRNP-PMH

  • Psychiatric/Mental Health Nurse Practitioner
  • Luthvle Timon, MD
National Provider Identifier
1346501616
Registry record updated Mar 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
R167684 Issued in MD
Practice address
1206 York Rd Ste 201
Luthvle Timon, MD 21093-6217
Phone
(410) 343-9839
NPI assigned
Jun 4, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X R167684 MD Primary

Addresses

Primary practice location

1206 York Rd Ste 201
Luthvle Timon, MD 21093-6217

Mailing address

126 Othoridge Rd
Lutherville, MD 21093-5418
Phone (410) 343-9869

Other practice location 1

6501 N Charles St
Suite 380
Baltimore, MD 21204-6819
Phone (410) 938-3000

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
I20130731000715 MD Practitioner - Nurse Practitioner 4688815798 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Resilient Psychiatry, LLCGroup PAC ID 1759793441, 8 clinicians

Practice addresses (Care Compare)

1206 York Rd
Suite 201
Lutherville, MD 21093-6217
Phone (410) 343-9869

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R167684MDMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sinai Hospital of Baltimore Inc CurrentSince Mar 23, 2016 Accepting new patients
Sinai Hospital of Baltimore, Inc. CurrentSince Mar 23, 2016 Accepting new patients
Resilient Psychiatry, LLC Psychiatric/Mental Health Current Accepting new patients
Sinai Hospital of Baltimore Inc Current Accepting new patients
Resilient Psychiatry, LLC Psychiatric/Mental Health CurrentSince Nov 1, 2020 Accepting new patients
Upmc Western Maryland Health Services, LLC Past Accepting new patients

Locations

2401 W Belvedere Ave
Baltimore, MD 21215

1206 York Rd
Ste 201
Luthvle Timon, MD 21093
Phone (410) 337-2626

828 Dulaney Valley Rd
Ste 12
Towson, MD 21204
Phone (410) 205-5123

Organizations & group practices 6

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": "1338768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741132800000",
    "number": "1346501616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "126 OTHORIDGE RD",
            "city": "LUTHERVILLE",
            "state": "MD",
            "postal_code": "210935418",
            "telephone_number": "410-343-9869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1206 YORK RD STE 201",
            "city": "LUTHVLE TIMON",
            "state": "MD",
            "postal_code": "210936217",
            "telephone_number": "410-343-9839"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6501 N Charles St",
            "address_2": "Suite 380",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212046819",
            "country_code": "US",
            "telephone_number": "410-938-3000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCKENZIE",
        "first_name": "ASHLEY",
        "middle_name": "NICOLE",
        "name_prefix": "Mrs.",
        "credential": "CRNP-PMH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-04",
        "last_updated": "2025-03-05",
        "certification_date": "2025-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R167684",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Luthvle Timon, MD

Sources for this page

Verify at the official NPI Registry.