Individual provider Active NPI

Tawanna Marie Deangelis, CRNP

  • Adult Health Nurse Practitioner
  • Baltimore, MD
National Provider Identifier
1376776237
Registry record updated Dec 30, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
R153735 Issued in MD
Practice address
3601 Odonnell St
Baltimore, MD 21224-5238
Phone
(443) 324-0645
NPI assigned
Aug 26, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X R153735 MD Primary

Addresses

Primary practice location

3601 Odonnell St
Baltimore, MD 21224-5238

Mailing address

3601 Odonnell St
Baltimore, MD 21224-5238
Phone (443) 324-0645

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
I20130627000705 MD Practitioner - Nurse Practitioner 8820237613 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Greater Baltimore Medical Center, Inc. CurrentSince Aug 1, 2016 Accepting new patients
Gilchrist Hospice Care, Inc. CurrentSince Jul 1, 2019 Accepting new patients
Gilchrist Hospice Care, Inc. CurrentSince Jul 1, 2019 Accepting new patients
Greater Baltimore Medical Center, Inc Current Accepting new patients
Greater Baltimore Medical Center, Inc. CurrentSince Aug 1, 2016 Accepting new patients

Locations

6569 N Charles St
Ste 505
Towson, MD 21204
Phone (443) 849-2196

6569 N Charles St
Ste 307
Towson, MD 21204
Phone (443) 849-2767

6701 N Charles St
Ste 4105
Towson, MD 21204
Phone (443) 849-3184

Interoperability endpoints

  • Direct secure messaging: tdeangelis18941@gbmcdirect.org

Organizations & group practices 5

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": "1251244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1293667200000",
    "number": "1376776237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3601 ODONNELL ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212245238",
            "telephone_number": "443-324-0645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 ODONNELL ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212245238",
            "telephone_number": "443-324-0645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEANGELIS",
        "first_name": "TAWANNA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-26",
        "last_updated": "2010-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MD",
            "license": "R153735",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.