NPIMap

Organization Active NPI

Toller Enterprises LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Randallstown, MD
National Provider Identifier
1063301430
Registry record updated Jul 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
TOLLER ENTERPRISES LLC
Practice address
9109 Liberty Rd
Randallstown, MD 21133-3521
Phone
(410) 655-7373
Fax
(410) 655-0579
NPI assigned
Jul 1, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2025

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

Authorized official

Name
Walter Lewis TollerNPI 1760060636
Title
Owner
Phone
(667) 207-3552

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208VP0000X
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

9109 Liberty Rd
Randallstown, MD 21133-3521

Mailing address

2232 E Monument St
Baltimore, MD 21205-2431
Phone (667) 207-3552

Other names 1

  • Patapsco Healthcare Other name

National Provider Directory

National Provider Directory
Tax ID family
Brighter Days Recovery Center42 organizations share this tax ID, including this one

Other organizations with this tax ID 41

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

View all 41

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1751328000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1751328000000",
    "number": "1063301430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2232 E MONUMENT ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212052431",
            "telephone_number": "667-207-3552",
            "fax_number": "443-885-9778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9109 LIBERTY RD",
            "city": "RANDALLSTOWN",
            "state": "MD",
            "postal_code": "211333521",
            "telephone_number": "410-655-7373",
            "fax_number": "410-655-0579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOLLER ENTERPRISES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-07-01",
        "last_updated": "2025-07-01",
        "certification_date": "2025-07-01",
        "status": "A",
        "authorized_official_last_name": "TOLLER",
        "authorized_official_first_name": "WALTER",
        "authorized_official_middle_name": "LEWIS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "667-207-3552"
    },
    "taxonomies": [
        {
            "code": "208VP0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Patapsco Healthcare",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Jul 1, 2025; 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.