Vincent A Renna
Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Conowingo, MD
NPI 1619735529 · NPPES record last updated Apr 11, 2024
Key facts
- NPI
- 1619735529
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- License
- R245171 (MD)
- Practice address
- 67 Martin Rd
Conowingo, MD 21918-1501 - Phone
- (443) 616-8483
- NPI assigned
- Mar 6, 2024
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Serene Wellness Psychiatry LLC
Practice addresses (Care Compare)
16 A Bel Air S Pkwy
Suite 321
Bel Air, MD 21015-6038
Phone (443) 616-8483
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MD
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240410001266 | MD | Practitioner - Nurse Practitioner | 0244678225 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R245171 | MD | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Serene Wellness Psychiatry LLC | Psychiatric/Mental Health | Current |
Accepting new patients |
Locations
16A Bel Air South Pkwy
Ste 321
Bel Air, MD 21015
Phone (410) 561-6207
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | R245171 | MD | Yes |
Addresses
Primary practice location
67 Martin Rd
Conowingo, MD 21918-1501
Mailing address
16A Bel Air South Pkwy Ste 321
Bel Air, MD 21015-6038
Phone (410) 561-6207
Other providers in Conowingo, MD
- Olamipo Odebode
- Cassie Nicole Peoples
- Rebecca R Poole
- Devon Ragan
- Sarah Reiman
- Jessica Ann Russell
- Donna M Sappah
- Ruth Laine Scott-Nelson
- Susan Lori Shafer
- Donald Steele
All providers in Conowingo, MD · Psychiatric/Mental Health Nurse Practitioner in Maryland
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 11, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.