NPIMap

Organization Active NPI

Total Health Care Inc

  • Federally Qualified Health Center (FQHC)
  • Baltimore, MD
National Provider Identifier
1013902485
Registry record updated Oct 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
TOTAL HEALTH CARE INC
Practice address
2401 Liberty Heights Ave Ste 111-113
Baltimore, MD 21215-8019
Phone
(410) 383-8300
Fax
(410) 383-3160
NPI assigned
Sep 13, 2005
Reactivated
Feb 7, 2011
Last updated
Oct 17, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2024

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

Authorized official

Name
Kevin D Bellamy
Title
Ceo
Phone
(410) 728-4090

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X NU Primary

Addresses

Primary practice location

2401 Liberty Heights Ave Ste 111-113
Baltimore, MD 21215-8019

Mailing address

1501 Division St
Baltimore, MD 21217-3121
Phone (410) 383-8300

Other identifiers 1

IdentifierTypeStateIssuer
905611400MedicaidMD

Other names 1

  • Mondawmin Health Center Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20070203000121 MD Part A Provider - Federally Qualified Health Center (FQHC) 0446258487 1 other NPI on this enrollment
Practice locations: Baltimore, MD
O20071107000802 MD Part B Supplier - Clinic/Group Practice 0446258487 Receives reassigned benefits from 107 practitioners
10 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Odenton, MD; Brooklyn, MD; Baltimore, MD

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1013902485. Details of each certification follow.

Federally qualified health center certification: CCN 211857

Legal name
TOTAL HEALTH CARE INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Mar 30, 2007
Last certification
Mar 30, 2007
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Jun 19, 1989 in MD
Enrollment address
2401 Liberty Heights Ave
Baltimore, MD 21215-8019

Other NPIs with the same Medicare PAC ID 8

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 10

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Total Health Care Inc29 organizations share this tax ID, including this one

Other organizations with this tax ID 28

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

View all 28

Locations

1501 W Saratoga St
Baltimore, MD 21223
Phone (410) 383-7197

Ownership & related parties

All disclosed owners & managing parties 8

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Gretchen M Spell Individual Corporate OfficerGovernance President Jan 1, 2016
Ashley Archie Individual Corporate OfficerBoard Member Jan 1, 2023
Donnell Henry Individual Corporate OfficerTreasurer Jan 1, 2023
Nichole M Boswell Individual Corporate OfficerSecretary Jan 1, 2023
Kevin D Bellamy Individual Corporate OfficerCeo Jan 1, 2018 100%
W-2 Managing EmployeeCeo Jan 1, 2018 100%
Teneah Lee Individual Corporate OfficerBoard Member Jan 1, 2023
H Duante Duckett Individual Corporate OfficerBoard Chair Jan 1, 2023
Michael Johnson Individual Corporate OfficerBoard Member Jan 1, 2023

Practitioners & affiliated clinicians

Practitioners 36

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 36

NPI Registry JSON

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

{
    "created_epoch": "1126569600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729123200000",
    "number": "1013902485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 DIVISION ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212173121",
            "telephone_number": "410-383-8300",
            "fax_number": "410-383-3160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 LIBERTY HEIGHTS AVE STE 111-113",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212158019",
            "telephone_number": "410-383-8300",
            "fax_number": "410-383-3160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOTAL HEALTH CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-13",
        "last_updated": "2024-10-17",
        "certification_date": "2024-10-17",
        "deactivation_date": "2007-04-04",
        "reactivation_date": "2011-02-07",
        "status": "A",
        "authorized_official_last_name": "BELLAMY",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "410-728-4090"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "905611400",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mondawmin Health Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.