NPIMap

Organization Active NPI

Healthways

  • Registered Nurse
  • Waldorf, MD
National Provider Identifier
1003108234
Registry record updated May 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
R165231 Issued in MD
Legal business name
HEALTHWAYS
Practice address
3209 Captain Dement Dr
Waldorf, MD 20603-6044
Phone
(202) 744-3445
NPI assigned
May 5, 2011
Last updated
May 5, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 5, 2011

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

Authorized official

Name
Kimberly Peacock, RN, BSN, CCM
Title
Office Manager
Phone
(202) 744-3445

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X R165231 MD Primary

Addresses

Primary practice location

3209 Captain Dement Dr
Waldorf, MD 20603-6044

Mailing address

3209 Captain Dement Dr
Waldorf, MD 20603-6044
Phone (202) 744-3445

National Provider Directory

National Provider Directory
Tax ID family
Healthways5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1304553600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1304553600000",
    "number": "1003108234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3209 CAPTAIN DEMENT DR",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206036044",
            "telephone_number": "202-744-3445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3209 CAPTAIN DEMENT DR",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206036044",
            "telephone_number": "202-744-3445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHWAYS",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-05",
        "last_updated": "2011-05-05",
        "status": "A",
        "authorized_official_last_name": "PEACOCK",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "202-744-3445",
        "authorized_official_credential": "RN, BSN, CCM"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MD",
            "license": "R165231",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waldorf, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2011; 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.