NPIMap

Organization Active NPI

Empowerment Healthcare Systems,LLC

  • Multi-Specialty Clinic/Center
  • Baltimore, MD
National Provider Identifier
1003314675
Registry record updated Oct 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
EMPOWERMENT HEALTHCARE SYSTEMS,LLC
Practice address
9106 Philadelphia Rd Ste 108B
Baltimore, MD 21237-4333
Phone
(410) 321-1961
Fax
(410) 321-1962
NPI assigned
Jan 29, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2024

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

Authorized official

Name
Dr. Damian AyichiNPI 1790111532
Title
Principal Associate/Ceo
Phone
(410) 321-1961

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X Primary
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X
Primary Care Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP2300X

Addresses

Primary practice location

9106 Philadelphia Rd Ste 108B
Baltimore, MD 21237-4333

Mailing address

PO Box 18844
Baltimore, MD 21206-0844
Phone (410) 321-1961

Other identifiers 1

IdentifierTypeStateIssuer
528016800MedicaidMD

Other names 1

  • EHS Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20181004002612 MD Part B Supplier - Clinic/Group Practice 4486906252 Receives reassigned benefits from 3 practitioners
Practice locations: Baltimore, MD

National Provider Directory

National Provider Directory
Tax ID family
Ehs2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

1055 Taylor Ave
Ste 205
Towson, MD 21286
Phone (410) 296-2004

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1517184000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727827200000",
    "number": "1003314675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 18844",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212060844",
            "telephone_number": "410-321-1961",
            "fax_number": "410-321-1962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9106 PHILADELPHIA RD STE 108B",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212374333",
            "telephone_number": "410-321-1961",
            "fax_number": "410-321-1962"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMPOWERMENT HEALTHCARE SYSTEMS,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-29",
        "last_updated": "2024-10-02",
        "certification_date": "2024-10-02",
        "status": "A",
        "authorized_official_last_name": "AYICHI",
        "authorized_official_first_name": "DAMIAN",
        "authorized_official_title_or_position": "PRINCIPAL ASSOCIATE/CEO",
        "authorized_official_telephone_number": "410-321-1961",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "528016800",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "EHS",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.