Mary Tola, CRNP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

R062454 Issued in MD

Practice address

12502 Willowbrook Rd
Suite 300
Cumberland, MD 21502-6491

Phone

(240) 964-8787

Fax

(240) 964-8687

NPI assigned

Jan 18, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

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.

• Upmc Western Maryland Health Services, LLC

  • Internal Medicine Physician
  • Cumberland, MD
  • NPI 1134844764
  NPD (past)

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416268800000",
    "number": "1588717367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12404 BUTLER DR NW",
            "city": "LAVALE",
            "state": "MD",
            "postal_code": "215026026",
            "telephone_number": "301-759-3968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12502 WILLOWBROOK RD",
            "address_2": "SUITE 300",
            "city": "CUMBERLAND",
            "state": "MD",
            "postal_code": "215026491",
            "telephone_number": "240-964-8787",
            "fax_number": "240-964-8687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOLA",
        "first_name": "MARY",
        "name_prefix": "Mrs.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-18",
        "last_updated": "2014-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MD",
            "license": "R062454",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "621091100",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elmer Noel Thompson III, M.D.
• Emily Thomsen
• Ladawn Tice, LCSW-C
• Beverly D. Tipton, NP-C
• Heather Lynn Togbetse, LCPC
• Tom Ghobrial, MD. LLC
• Cherokee Torbet, FNP-BC
• Kailee Torbet, OTA
• Spencer Torgerson
• Transitioncare LLC

• Adult Health Nurse Practitioner in Cumberland, MD
• Providers in Cumberland, MD by specialty
• Adult Health Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.