GT Healthcare Inc

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

GT HEALTHCARE INC

Practice address

10515 Theodore Green Blvd Ste 212
White Plains, MD 20695-3044

Phone

(202) 246-3013

Fax

(202) 246-3013

NPI assigned

May 11, 2022

Organization subpart

No

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

Authorized official

Name

Oluwatosin Fanimo, PMHNP

Title

Owner/Provider

Phone

(202) 246-3013

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1652227200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1652227200000",
    "number": "1003552159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10515 THEODORE GREEN BLVD STE 212",
            "city": "WHITE PLAINS",
            "state": "MD",
            "postal_code": "206953044",
            "telephone_number": "202-246-3013",
            "fax_number": "202-246-3013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10515 THEODORE GREEN BLVD STE 212",
            "city": "WHITE PLAINS",
            "state": "MD",
            "postal_code": "206953044",
            "telephone_number": "202-246-3013",
            "fax_number": "202-246-3013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GT HEALTHCARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-11",
        "last_updated": "2022-05-11",
        "certification_date": "2022-05-11",
        "status": "A",
        "authorized_official_last_name": "FANIMO",
        "authorized_official_first_name": "OLUWATOSIN",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "202-246-3013",
        "authorized_official_credential": "PMHNP"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2022; 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.