Active NPI
Renay Tyler, ACNP
- Nutrition Support Registered Nurse
- Baltimore, MD
National Provider Identifier
1548327083
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nutrition Support Registered Nurse
- License
- R072779
- Practice address
- 600 N Wolfe St
Baltimore, MD 21287-0005 - Phone
- (410) 502-2590
- Fax
- (410) 955-4870
- NPI assigned
- Jan 3, 2007
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nutrition Support Registered Nurse | 163WN1003X | R072779 | MD | Primary |
| Acute Care Nurse Practitioner | 363LA2100X | R072779 | MD |
Addresses
Primary practice location
600 N Wolfe St
Baltimore, MD 21287-0005
Mailing address
1120 Ryegate Rd
Towson, MD 21286-1745
Phone (410) 583-5299
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: Yes
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R072779 | MD | MD | Acute Care Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University of Maryland Community Medical Group, Inc. | Current | Accepting new patients | |
| University of Maryland Community Medical Group, Inc. | Current | Accepting new patients | |
| Maryland General Clinical Practice Group, Inc. | Current | Accepting new patients | |
| Maryland General Clinical Practice Group, Inc. | Current | Accepting new patients |
Locations
827 Linden Ave
Baltimore, MD 21201
Phone (410) 225-8100
2540 Centreville Rd
Centreville, MD 21617
Phone (410) 758-4432
301 Hospital Dr
Glen Burnie, MD 21061
Phone (410) 787-4565
920 Elkridge Landing Rd
Linthicum Heights, MD 21090
Organizations & group practices 4
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.
-
- Psychiatry Physician
- Baltimore, MD
- NPI 1689413197
-
- Multi-Specialty Clinic/Center
- Baltimore, MD
- NPI 1770684805
-
- Family Medicine Physician
- Baltimore, MD
- NPI 1477530624
-
- Psychiatry Physician
- La Plata, MD
- NPI 1679393854
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167782400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757548800000",
"number": "1548327083",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1120 RYEGATE RD",
"city": "TOWSON",
"state": "MD",
"postal_code": "212861745",
"telephone_number": "410-583-5299"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "600 N WOLFE ST",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212870005",
"telephone_number": "410-502-2590",
"fax_number": "410-955-4870"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TYLER",
"first_name": "RENAY",
"credential": "ACNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-03",
"last_updated": "2025-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "163WN1003X",
"taxonomy_group": "",
"desc": "Registered Nurse, Nutrition Support",
"state": "MD",
"license": "R072779",
"primary": true
},
{
"code": "363LA2100X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Acute Care",
"state": "MD",
"license": "R072779",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Baltimore, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.