Active NPI
Tennille Craig
- Social Worker
- Gaithersburg, MD
National Provider Identifier
1487075362
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- LGP5123
- Practice address
- 16220 Frederick Rd
310
Gaithersburg, MD 20877-4039 - Phone
- (301) 345-1022
- NPI assigned
- Dec 19, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | LGP5123 | MD | Primary |
Addresses
Primary practice location
16220 Frederick Rd
310
Gaithersburg, MD 20877-4039
Mailing address
16220 Frederick Rd
310
Gaithersburg, MD 20877-4039
Phone (301) 345-1022
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LGP5123 | MD | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1387411200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1726099200000",
"number": "1487075362",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16220 FREDERICK RD",
"address_2": "310",
"city": "GAITHERSBURG",
"state": "MD",
"postal_code": "208774039",
"telephone_number": "301-345-1022"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16220 FREDERICK RD",
"address_2": "310",
"city": "GAITHERSBURG",
"state": "MD",
"postal_code": "208774039",
"telephone_number": "301-345-1022"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CRAIG",
"first_name": "TENNILLE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-12-19",
"last_updated": "2024-09-12",
"certification_date": "2024-09-05",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "MD",
"license": "LGP5123",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gaithersburg, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.