NPIMap

Organization Active NPI

Change Health Systems, Inc

  • Physical Therapy Clinic/Center
  • Baltimore, MD
National Provider Identifier
1093236200
Registry record updated Jun 28, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
CHANGE HEALTH SYSTEMS, INC
Practice address
300 W Lexington St
Baltimore, MD 21201-3418
Phone
(410) 233-1088
NPI assigned
Jun 28, 2017
Last updated
Jun 28, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2017

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

Authorized official

Name
Mr. Israel Olaoluwasupo Ojo, MSW
Title
Ceo/Program Director
Phone
(410) 233-1088

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X NU Primary

Addresses

Primary practice location

300 W Lexington St
Baltimore, MD 21201-3418

Mailing address

2401 Liberty Heights Ave
Baltimore, MD 21215-8019
Phone (410) 233-1088

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090317000486 MD Part B Supplier - Clinic/Group Practice 9335206465 Receives reassigned benefits from 10 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Baltimore, MD; Hagerstown, MD

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 14

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.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1498608000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1498608000000",
    "number": "1093236200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2401 LIBERTY HEIGHTS AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212158019",
            "telephone_number": "410-233-1088",
            "fax_number": "410-233-1087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 W LEXINGTON ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212013418",
            "telephone_number": "410-233-1088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHANGE HEALTH SYSTEMS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-28",
        "last_updated": "2017-06-28",
        "status": "A",
        "authorized_official_last_name": "OJO",
        "authorized_official_first_name": "ISRAEL",
        "authorized_official_middle_name": "OLAOLUWASUPO",
        "authorized_official_title_or_position": "CEO/PROGRAM DIRECTOR",
        "authorized_official_telephone_number": "410-233-1088",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MSW"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "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 Jun 28, 2017; 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.