Dynamic Supports , LLC

Primary specialty

Developmental Disabilities Clinic/CenterTaxonomy code 261QD1600X

Legal business name

DYNAMIC SUPPORTS , LLC

Practice address

9510 Sycamore GRV
Upper Marlboro, MD 20772-2698

Phone

(217) 691-8938

NPI assigned

Jan 4, 2021

Last updated

Feb 14, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Oluseye Jeje, MPH

Title

Ceo

Phone

(217) 691-8938

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

{
    "created_epoch": "1609718400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644796800000",
    "number": "1043808272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9510 SYCAMORE GRV",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "207722698",
            "telephone_number": "217-691-8938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9510 SYCAMORE GRV",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "207722698",
            "telephone_number": "217-691-8938"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1629 K St NW Ste 300",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "200061631",
            "country_code": "US",
            "telephone_number": "217-691-8938",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "DYNAMIC SUPPORTS , LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-04",
        "last_updated": "2022-02-14",
        "certification_date": "2022-02-14",
        "status": "A",
        "authorized_official_last_name": "JEJE",
        "authorized_official_first_name": "OLUSEYE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "217-691-8938",
        "authorized_official_credential": "MPH"
    },
    "taxonomies": [
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Laptop",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "9510 Sycamore Grv",
            "city": "Upper Marlboro",
            "state": "MD",
            "country_code": "US",
            "postal_code": "207722698",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Developmental Disabilities Clinic/Center in Upper Marlboro, MD
• Providers in Upper Marlboro, MD by specialty
• Developmental Disabilities Clinic/Center in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 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.