Individual provider Active NPI

Renay Tyler, ACNP

  • Nutrition Support Registered Nurse
  • Baltimore, MD
National Provider Identifier
1548327083
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nutrition Support Registered NurseTaxonomy code 163WN1003X
License
R072779 Issued in MD
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

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R072779MDMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University of Maryland Community Medical Group, Inc. CurrentSince Jul 1, 2019 Accepting new patients
University of Maryland Community Medical Group, Inc. CurrentSince Jul 1, 2019 Accepting new patients
Maryland General Clinical Practice Group, Inc. CurrentSince Aug 12, 2019 Accepting new patients
Maryland General Clinical Practice Group, Inc. CurrentSince Aug 12, 2019 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.

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

Verify at the official NPI Registry.