NPIMap

Organization Active NPI

Peace & Glory Manor, LLC

  • Nurse's Aide
  • Randallstown, MD
National Provider Identifier
1023344066
Registry record updated Oct 27, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse's AideTaxonomy code 376K00000X
License
03AL1070-A Issued in MD
Legal business name
PEACE & GLORY MANOR, LLC
Practice address
3829 Kilburn Rd
Randallstown, MD 21133-4655
Phone
(410) 922-2617
Fax
(410) 922-4620
NPI assigned
Oct 27, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2009

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

Authorized official

Name
Ms. Gloria Lynn Brown - Bristol
Title
Founder Coe/ Excutive Offer
Phone
(410) 922-2617

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Care Registered NurseGroup: 193200000X MULTI-SPECIALTY GROUP 163WP2201X 03AL1070-A MD
Wound Care Registered NurseGroup: 193200000X MULTI-SPECIALTY GROUP 163WW0000X 03AL1070-A MD
Bus 347B00000X 03AL1070-A MD
Private Vehicle 347C00000X 03AL1070-A MD
Adult CompanionGroup: 193200000X MULTI-SPECIALTY GROUP 372600000X 03AL1070-A MD
Attendant Care ProviderGroup: 193200000X MULTI-SPECIALTY GROUP 3747A0650X 03AL1070-A MD
Personal Care AttendantGroup: 193200000X MULTI-SPECIALTY GROUP 3747P1801X 03AL1070-A MD
Nurse's AideGroup: 193200000X MULTI-SPECIALTY GROUP 376K00000X 03AL1070-A MD Primary

Addresses

Primary practice location

3829 Kilburn Rd
Randallstown, MD 21133-4655

Mailing address

3829 Kilburn Rd
Randallstown, MD 21133-4655
Phone (410) 922-2617

National Provider Directory

National Provider Directory
Tax ID family
Peace Glory Manor LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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": "1256601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1256601600000",
    "number": "1023344066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3829 KILBURN RD",
            "city": "RANDALLSTOWN",
            "state": "MD",
            "postal_code": "211334655",
            "telephone_number": "410-922-2617",
            "fax_number": "410-922-4620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3829 KILBURN RD",
            "city": "RANDALLSTOWN",
            "state": "MD",
            "postal_code": "211334655",
            "telephone_number": "410-922-2617",
            "fax_number": "410-922-4620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEACE & GLORY MANOR, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-27",
        "last_updated": "2009-10-27",
        "status": "A",
        "authorized_official_last_name": "BROWN - BRISTOL",
        "authorized_official_first_name": "GLORIA",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "FOUNDER COE/ EXCUTIVE OFFER",
        "authorized_official_telephone_number": "410-922-2617",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "163WP2201X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Ambulatory Care",
            "state": "MD",
            "license": "03AL1070-A",
            "primary": false
        },
        {
            "code": "163WW0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Wound Care",
            "state": "MD",
            "license": "03AL1070-A",
            "primary": false
        },
        {
            "code": "347B00000X",
            "taxonomy_group": "",
            "desc": "Bus",
            "state": "MD",
            "license": "03AL1070-A",
            "primary": false
        },
        {
            "code": "347C00000X",
            "taxonomy_group": "",
            "desc": "Private Vehicle",
            "state": "MD",
            "license": "03AL1070-A",
            "primary": false
        },
        {
            "code": "372600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Adult Companion",
            "state": "MD",
            "license": "03AL1070-A",
            "primary": false
        },
        {
            "code": "3747A0650X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Technician, Attendant Care Provider",
            "state": "MD",
            "license": "03AL1070-A",
            "primary": false
        },
        {
            "code": "3747P1801X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Technician, Personal Care Attendant",
            "state": "MD",
            "license": "03AL1070-A",
            "primary": false
        },
        {
            "code": "376K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse's Aide",
            "state": "MD",
            "license": "03AL1070-A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Randallstown, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2009; 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.