Tinisha Jordan Cheatham, DO
Individual provider Active NPI Family Medicine Physician · Halethorpe, MD
NPI 1851339618 · NPPES record last updated Jun 16, 2021
Key facts
- NPI
- 1851339618
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- H0059884 (MD)
- Practice address
- 1701 Twin Springs Rd
Halethorpe, MD 21227-3553 - Phone
- (410) 737-5000
- NPI assigned
- Jun 3, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in DC, MD
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040511001396 | DC | Practitioner - Family Practice | 0345239570 | Reassigns benefits to 1 organization |
| I20210526000970 | MD | Practitioner - Family Practice | 0345239570 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DO34139 | DC | MD | Family Medicine Physician |
| H0059884 | MD | MD | Family Medicine Physician |
| 0102201407 | VA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kaiser Foundation Health Plan of the Mid Atlantic States, Inc | Current |
Accepting new patients | |
| Kaiser Foundation Health Plan of the Mid Atlantic States, Inc | Family Medicine | Current |
Accepting new patients |
Locations
7070 Samuel Morse Dr
Columbia, MD 21046
Phone (410) 309-4600
1701 Twin Springs Rd
Halethorpe, MD 21227
Phone (410) 737-5000
4920 Campbell Blvd
Nottingham, MD 21236
Phone (410) 933-7600
2101 E Jefferson St
Rockville, MD 20852
Phone (301) 816-6660
2101 E Jefferson St
#4
Rockville, MD 20852
2101 E Jefferson St
#4E
Rockville, MD 20852
2101 E Jefferson St
Ste 6WPPQA
Rockville, MD 20852
Phone (301) 816-5853
5100 Auth Way
Suitland, MD 20746
Phone (301) 702-5000
6104 Old Branch Ave
Temple Hills, MD 20748
Phone (301) 702-6100
1221 Mercantile Ln
Upper Marlboro, MD 20774
Phone (301) 618-5500
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | DO34139 | DC | |
| Family Medicine Physician | 207Q00000X | 0102201407 | VA | |
| Family Medicine Physician | 207Q00000X | H0059884 | MD | Yes |
Addresses
Primary practice location
1701 Twin Springs Rd
Halethorpe, MD 21227-3553
Mailing address
2101 E Jefferson St
Kaiser Permanente Medicare Enrollment
Rockville, MD 20852-4908
Phone (301) 816-2424
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 403759600 | Medicaid | MD |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggateways | Health Information Exchange (HIE) |
Other providers in Halethorpe, MD
- Elizabeth M Carter
- Caron Marie Casciato
- Grace Gia-Ling Wong Casserly
- Martha J Chalmers
- Shanita Chase
- Sang Cheon
- Andrew CHI
- Grace Choi
- Adeel Khalid Choudhary
- Proma Chowdhury
All providers in Halethorpe, MD · Family Medicine Physician in Maryland
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 16, 2021. 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).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.