Tynnetta Graham, CRNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R153464 Issued in MD

Practice address

1000 Cathedral St
Baltimore, MD 21201-5418

Phone

(410) 396-1295

NPI assigned

Aug 9, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Tynnetta Dawson Former name

Medicare fee-for-service enrollment

Enrolled in MD, DC2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Medstar Health Weight Management, LLCGroup PAC ID 0840634267, 103 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse, Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: graham.tynnetta@ca-md.direct.office.nextgen.com
• FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

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.

• Medstar Health Weight Management, LLC

  • Family Medicine Physician
  • Linthicum Heights, MD
  • NPI 1013785971

  DC

  Medicare reassignment Care Compare group NPD
• University of Maryland Community Medical Group, Inc.

  • Family Medicine Physician
  • Baltimore, MD
  • NPI 1477530624
  Medicare reassignment NPD
• Maryland General Clinical Practice Group, Inc.

  • Multi-Specialty Clinic/Center
  • Baltimore, MD
  • NPI 1770684805
  Medicare reassignment
• University of Maryland Community Medical Group, Inc.

  • Psychiatry Physician
  • La Plata, MD
  • NPI 1679393854
  NPD
• University Care

  • Health Service Psychologist
  • Baltimore, MD
  • NPI 1629210166
  NPD (past)
• University Care LLC

  • Family Medicine Physician
  • Baltimore, MD
  • NPI 1497760276
  NPD (past)
• University of Maryland Family Medicine Associates, P.a.

  • Specialist
  • Baltimore, MD
  • NPI 1053424994
  NPD (past)

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

{
    "created_epoch": "1155081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555545600000",
    "number": "1578573440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 64888",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212644888",
            "telephone_number": "301-631-8101",
            "fax_number": "301-631-1002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 CATHEDRAL ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212015418",
            "telephone_number": "410-396-1295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "TYNNETTA",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-09",
        "last_updated": "2019-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MD",
            "license": "R153464",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R153464",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "406596000",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TYNNETTA",
            "last_name": "DAWSON",
            "credential": "CRNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Michelle Graham
• Robert Leroy Graham Sr.
• Sheila Vanessa Graham, PH.D.
• Stacey A Graham, ACNP-BC
• Syreeta Janae Graham, CAC-AD
• Christina Renee Graley
• Aneta P. Gramatikova, M.D.
• Amy Grammas, CRNP-PMH
• Julie Grammatico
• Gramps Assisted Living

• Family Nurse Practitioner in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Family Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2019; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.