1679520779 NPI number — KATHLEEN ANNE RANNEY MD

Table of content: KRISTIN MARIE COLLINS (NPI 1871715979)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1679520779 NPI number — KATHLEEN ANNE RANNEY MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RANNEY
Provider First Name:
KATHLEEN
Provider Middle Name:
ANNE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1679520779
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/17/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 64374
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BALTIMORE
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21264-4273
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
410-328-6720
Provider Business Mailing Address Fax Number:
410-328-1674

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
110 S PACA ST
Provider Second Line Business Practice Location Address:
6TH FLOOR, SUITE 300
Provider Business Practice Location Address City Name:
BALTIMORE
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21201-1642
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-328-6331
Provider Business Practice Location Address Fax Number:
410-328-1674
Provider Enumeration Date:
05/27/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207L00000X , with the licence number:  D0055755 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207L00000X , with the licence number: 0101056090 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207L00000X , with the licence number: D55755 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 601285800 . This is a "FECA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 125218600 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
  • Identifier: P00745077 . This is a "RR MEDICARE (GRP PTAN DD6120)" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: S417-0017 . This is a "CAREFIRST BCBS" identifier , issued by the state of ( DC ) . This identifiers is of the category "OTHER".
  • Identifier: KBC1CH . This is a "CAREFIRST BCBS" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".




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