Winchester Health LLC

Primary specialty

Methadone ClinicTaxonomy code 261QM2800X

Legal business name

WINCHESTER HEALTH LLC

Practice address

1315 Bloomingdale Rd
Baltimore, MD 21216-3922

Phone

(410) 484-8500

NPI assigned

May 16, 2018

Organization subpart

No

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

Authorized official

Name

Amiel Chicheportiche

Title

Director

Phone

(410) 258-8939

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MD

Opioid treatment program

Medicare-enrolled since Jan 1, 2020

Enrollment records 1

Tax ID family

Winchester Health LLC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

• Winchester Health LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Baltimore, MD
  • NPI 1659861607
  NPD tax ID
• Winchester Health LLC

  • Community/Behavioral Health Agency
  • Baltimore, MD
  • NPI 1679103360
  NPD tax ID
• Winchester Health LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Baltimore, MD
  • NPI 1982344131
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mohammed G Kiddugavu, MD

  • Internal Medicine Physician
  • Randallstown, MD
  • NPI 1952446601
  NPD

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

{
    "created_epoch": "1526428800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733184000000",
    "number": "1053801951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2833 SMITH AVE STE 148",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212091426",
            "telephone_number": "410-624-7111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1315 BLOOMINGDALE RD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212163922",
            "telephone_number": "410-484-8500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WINCHESTER HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-16",
        "last_updated": "2024-12-03",
        "certification_date": "2024-12-03",
        "status": "A",
        "authorized_official_last_name": "CHICHEPORTICHE",
        "authorized_official_first_name": "AMIEL",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "410-258-8939"
    },
    "taxonomies": [
        {
            "code": "261QM2800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Methadone",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "BH001216",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Win Team, LLC
• Shwe Yee Win, M.D.
• Shannon J Winakur, M.D.
• Naomi S Winbush
• Jessica Wince
• Winchester Health LLC
• Winchester Health LLC
• Winchester Health LLC
• Winchester House LLC
• Aniya Winchester

• Methadone Clinic in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Methadone Clinic in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.