NPIMap

Organization Active NPI

Modern Integrative Healthcare

  • Integrative Medicine Physician
  • Laurel, MD
National Provider Identifier
1073201943
Registry record updated Apr 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Integrative Medicine PhysicianTaxonomy code 202D00000X
Legal business name
MODERN INTEGRATIVE HEALTHCARE
Practice address
9101 Cherry LN Ste 205
Laurel, MD 20708-1151
Phone
(301) 317-7912
Fax
(301) 498-2094
NPI assigned
Apr 27, 2023
Last updated
Apr 27, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2023

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

Authorized official

Name
Dr. Schmekia M Jackson, D.C.NPI 1235486341
Title
Ceo/Owner
Phone
(410) 908-4881

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
Integrative Medicine Physician 202D00000X Primary

Addresses

Primary practice location

9101 Cherry LN Ste 205
Laurel, MD 20708-1151

Mailing address

PO Box 648
Bowie, MD 20718-0648
Phone (301) 317-7912

National Provider Directory

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": "1682553600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682553600000",
    "number": "1073201943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 648",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207180648",
            "telephone_number": "301-317-7912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9101 CHERRY LN STE 205",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207081151",
            "telephone_number": "301-317-7912",
            "fax_number": "301-498-2094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MODERN INTEGRATIVE HEALTHCARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-27",
        "last_updated": "2023-04-27",
        "certification_date": "2023-04-27",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "SCHMEKIA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CEO/OWNER",
        "authorized_official_telephone_number": "410-908-4881",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "202D00000X",
            "taxonomy_group": "",
            "desc": "Integrative Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laurel, MD

Sources for this page

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