NPIMap

Organization Active NPI

Prince George'S County Health Department

  • Student Health Clinic/Center
  • Oxon Hill, MD
National Provider Identifier
1083102438
Registry record updated Feb 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student Health Clinic/CenterTaxonomy code 261QS1000X
Legal business name
PRINCE GEORGE'S COUNTY HEALTH DEPARTMENT
Practice address
6701 Leyte Drive
Oxon Hill, MD 20745
Phone
(240) 724-1442
NPI assigned
May 1, 2018
Organization subpart
Yes
Parent organization
PRINCE GEORGE'S COUNTY HEALTH DEPARTMENTAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 26, 2020

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

Authorized official

Name
Tamala Butler
Title
Credentialing Specialist
Phone
(301) 883-7822

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adolescent Medicine (Family Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207QA0000X
Student Health Clinic/Center 261QS1000X Primary

Addresses

Primary practice location

6701 Leyte Drive
Oxon Hill, MD 20745

Mailing address

1701 McCormick Dr Ste 120
Largo, MD 20774-5329

Other names 2

  • Oxon Hill- School Based Wellness Other name
  • Prince George's County Health Department-SBW- Oxon HIll Other name

National Provider Directory

National Provider Directory
Tax ID family
Prince Georges County48 organizations share this tax ID, including this one
Part of
Prince Georges County

Other organizations with this tax ID 47

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

View all 47

NPI Registry JSON

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

{
    "created_epoch": "1525132800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1582675200000",
    "number": "1083102438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 MCCORMICK DR STE 120",
            "city": "LARGO",
            "state": "MD",
            "postal_code": "207745329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6701 LEYTE DRIVE",
            "city": "OXON HILL",
            "state": "MD",
            "postal_code": "20745",
            "telephone_number": "240-724-1442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRINCE GEORGE'S COUNTY HEALTH DEPARTMENT",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PRINCE GEORGE'S COUNTY HEALTH DEPARTMENT",
        "enumeration_date": "2018-05-01",
        "last_updated": "2020-02-26",
        "certification_date": "2020-02-26",
        "status": "A",
        "authorized_official_last_name": "BUTLER",
        "authorized_official_first_name": "TAMALA",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "301-883-7822"
    },
    "taxonomies": [
        {
            "code": "207QA0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Adolescent Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QS1000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Student Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Oxon Hill- School Based Wellness",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Prince George's County Health Department-SBW- Oxon HIll",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Oxon Hill, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2020; 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.