Individual provider Active NPI

Canicia Anyiatem, CRNP-PMH

  • Psychiatric/Mental Health Nurse Practitioner
  • Hyattsville, MD
National Provider Identifier
1932465382
Registry record updated Apr 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
R216688 Issued in MD
Practice address
7707 Swan Ter
Hyattsville, MD 20785-4680
Phone
(202) 545-0935
NPI assigned
Apr 10, 2012
Last updated
Apr 20, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 20, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X R216688 MD Primary
Home Health Aide 374U00000X NU

Addresses

Primary practice location

7707 Swan Ter
Hyattsville, MD 20785-4680

Mailing address

7707 Swan Ter
Hyattsville, MD 20785-4680
Phone (301) 336-3076

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20201119000216 MD Practitioner - Nurse Practitioner 6103237300 Reassigns benefits to 1 organization
I20230517002439 DC Practitioner - Nurse Practitioner 6103237300 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Psychiatry Specialities Clinics LLCGroup PAC ID 8921344722, 2 clinicians

Practice addresses (Care Compare)

3525 Ellicott Mills Dr
Suite G
Ellicott City, MD 21043-4638
Phone (410) 988-8092

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R216688MDMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Canrina Nurturing Minds Behavioral Health Care LLC CurrentSince Feb 23, 2023 Accepting new patients
Psychiatry Specialities Clinics, LLC Psychiatric/Mental Health CurrentSince Dec 1, 2020 Accepting new patients

Locations

3525 Ellicott Mills Dr
Ellicott City, MD 21043
Phone (443) 618-8947

3525 Ellicott Mills Dr
Ste G
Ellicott City, MD 21043
Phone (301) 778-4431

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1334016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587340800000",
    "number": "1932465382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7707 SWAN TER",
            "city": "HYATTSVILLE",
            "state": "MD",
            "postal_code": "207854680",
            "telephone_number": "301-336-3076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7707 SWAN TER",
            "city": "HYATTSVILLE",
            "state": "MD",
            "postal_code": "207854680",
            "telephone_number": "202-545-0935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANYIATEM",
        "first_name": "CANICIA",
        "credential": "CRNP-PMH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-04-10",
        "last_updated": "2020-04-20",
        "certification_date": "2020-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R216688",
            "primary": true
        },
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hyattsville, MD

Sources for this page

Verify at the official NPI Registry.