NPIMap

Organization Active NPI

Holistic Health and Wellness LLC

  • Family Medicine Physician
  • Baltimore, MD
National Provider Identifier
1063113132
Registry record updated Mar 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
HOLISTIC HEALTH AND WELLNESS LLC
Practice address
1105 N Point Blvd Ste 321
Baltimore, MD 21224-3472
Phone
(410) 517-7060
Fax
(443) 407-2942
NPI assigned
Mar 15, 2023
Last updated
Mar 15, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2023

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

Authorized official

Name
Michelle BlackstonNPI 1194277152
Title
Medical Director
Phone
(410) 517-7060

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

1105 N Point Blvd Ste 321
Baltimore, MD 21224-3472

Mailing address

1105 N Point Blvd Ste 321
Baltimore, MD 21224-3472
Phone (410) 517-7060

National Provider Directory

National Provider Directory
Tax ID family
Holistic Health and Wellness 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.

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1678838400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678838400000",
    "number": "1063113132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1105 N POINT BLVD STE 321",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212243472",
            "telephone_number": "410-517-7060",
            "fax_number": "443-407-2942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1105 N POINT BLVD STE 321",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212243472",
            "telephone_number": "410-517-7060",
            "fax_number": "443-407-2942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLISTIC HEALTH AND WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-15",
        "last_updated": "2023-03-15",
        "certification_date": "2023-03-15",
        "status": "A",
        "authorized_official_last_name": "BLACKSTON",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "410-517-7060"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2023; 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.