Individual provider Active NPI

Tracy D Vannorsdall, PH.D.

  • Psychologist
  • Baltimore, MD
National Provider Identifier
1457498511
Registry record updated Oct 29, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
04467 Issued in MD
Practice address
600 N Wolfe St
Meyer 218
Baltimore, MD 21287-0005
Phone
(410) 955-3268
Fax
(410) 955-0504
NPI assigned
Jan 30, 2007
Last updated
Oct 29, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X MD
Psychologist 103T00000X 04467 MD Primary

Addresses

Primary practice location

600 N Wolfe St
Meyer 218
Baltimore, MD 21287-0005

Mailing address

600 N Wolfe St
Meyer 218
Baltimore, MD 21287-0005
Phone (410) 955-3268

Other identifiers 1

IdentifierTypeStateIssuer
023328500MedicaidMD

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
I20091016000493 MD Practitioner - Clinical Psychologist 1355488792 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2006
Medicare assignment
May accept Medicare assignment
Group practices
Johns Hopkins UniversityGroup PAC ID 8921903147, 2,886 clinicians

Practice addresses (Care Compare)

10755 Falls Rd
Lutherville, MD 21093-4515
Phone (443) 997-0400

600 N Wolf St
Baltimore, MD 21287-0005
Phone (410) 955-5000

600 N Wolfe St
Blalock 266
Baltimore, MD 21287-0005
Phone (410) 502-4340

6201 Greenleigh Ave
Middle River, MD 21220-2004

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.31 of 100Reported as group
Quality
73.89
Promoting interoperability
100
Improvement activities
40
Cost
70.47

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
04467MDMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Johns Hopkins University CurrentSince Jul 1, 2009 Accepting new patients
Johns Hopkins University Psychologist CurrentSince Jul 1, 2009 Accepting new patients
Johns Hopkins University Current Accepting new patients

Locations

600 N Wolfe St
Baltimore, MD 21287

600 N Wolfe St
#218
Baltimore, MD 21287
Phone (410) 502-6343

10755 Falls Rd
Timonium, MD 21093
Phone (410) 583-2727

Interoperability endpoints

  • Direct secure messaging: tvannorsdall37058@direct.hopkinsmedicine.org

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1256774400000",
    "number": "1457498511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 N WOLFE ST",
            "address_2": "MEYER 218",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212870005",
            "telephone_number": "410-955-3268",
            "fax_number": "410-955-0504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 N WOLFE ST",
            "address_2": "MEYER 218",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212870005",
            "telephone_number": "410-955-3268",
            "fax_number": "410-955-0504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANNORSDALL",
        "first_name": "TRACY",
        "middle_name": "D",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-30",
        "last_updated": "2009-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MD",
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MD",
            "license": "04467",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "023328500",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.