Active NPI
Purpose Health LLC
- Addiction Medicine (Preventive Medicine) Physician
- Elkton, MD
National Provider Identifier
1093331639
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction Medicine (Preventive Medicine) Physician
- Legal business name
- PURPOSE HEALTH LLC
- Practice address
- 101 Chesapeake Blvd
Elkton, MD 21921-6607 - Phone
- (410) 398-0590
- Fax
- (443) 240-3838
- NPI assigned
- Jun 19, 2020
- Last updated
- Jun 19, 2020
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mary Halsey
- Title
- Administrator
- Phone
- (443) 553-0057
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction Medicine (Family Medicine) Physician | 207QA0401X | |||
| Addiction Medicine (Preventive Medicine) Physician | 2083A0300X | Primary |
Addresses
Primary practice location
101 Chesapeake Blvd
Elkton, MD 21921-6607
Mailing address
101 Chesapeake Blvd
Elkton, MD 21921-6607
Phone (410) 398-0590
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043323827 | Medicaid | MD |
National Provider Directory
National Provider DirectoryLocations
101 Chesapeake Blvd
Elkton, MD 21921
Phone (301) 498-0384
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1592524800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1592524800000",
"number": "1093331639",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "101 CHESAPEAKE BLVD",
"city": "ELKTON",
"state": "MD",
"postal_code": "219216607",
"telephone_number": "410-398-0590",
"fax_number": "443-240-3838"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 CHESAPEAKE BLVD",
"city": "ELKTON",
"state": "MD",
"postal_code": "219216607",
"telephone_number": "410-398-0590",
"fax_number": "443-240-3838"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PURPOSE HEALTH LLC",
"organizational_subpart": "NO",
"enumeration_date": "2020-06-19",
"last_updated": "2020-06-19",
"certification_date": "2020-06-19",
"status": "A",
"authorized_official_last_name": "HALSEY",
"authorized_official_first_name": "MARY",
"authorized_official_title_or_position": "ADMINISTRATOR",
"authorized_official_telephone_number": "443-553-0057"
},
"taxonomies": [
{
"code": "207QA0401X",
"taxonomy_group": "",
"desc": "Family Medicine, Addiction Medicine",
"state": null,
"license": null,
"primary": false
},
{
"code": "2083A0300X",
"taxonomy_group": "",
"desc": "Preventive Medicine, Addiction Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1043323827",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Elkton, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 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.