NPIMap

Organization Active NPI

Healthy States

  • Family Nurse Practitioner
  • Upper Marlboro, MD
National Provider Identifier
1003668690
Registry record updated Apr 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
HEALTHY STATES
Practice address
10010 Goldenwood CT
Upper Marlboro, MD 20772-3685
Phone
(305) 588-3546
NPI assigned
Apr 5, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2024

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

Authorized official

Name
Traci HammelNPI 1134452733
Title
Owner
Phone
(305) 588-3546

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X Primary
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X

Addresses

Primary practice location

10010 Goldenwood CT
Upper Marlboro, MD 20772-3685

Mailing address

3717 Boston St Ste 267
Baltimore, MD 21224-5752

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1712275200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712275200000",
    "number": "1003668690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3717 BOSTON ST STE 267",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212245752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10010 GOLDENWOOD CT",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "207723685",
            "telephone_number": "305-588-3546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHY STATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-05",
        "last_updated": "2024-04-05",
        "certification_date": "2024-01-02",
        "status": "A",
        "authorized_official_last_name": "HAMMEL",
        "authorized_official_first_name": "TRACI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "305-588-3546"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "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
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Upper Marlboro, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2024; 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.