NPIMap

Organization Active NPI

Epiphany Family Services Maryland LLC

  • Primary Care Clinic/Center
  • Baltimore, MD
National Provider Identifier
1093364077
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
EPIPHANY FAMILY SERVICES MARYLAND LLC
Practice address
3301 Belair Rd Ste 2
Baltimore, MD 21213-1257
Phone
(410) 873-7193
Fax
(410) 630-7882
NPI assigned
Sep 11, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Authorized official

Name
Anthony EstreetNPI 1538446786
Title
Ceo
Phone
(443) 873-7193

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
Community Health Clinic/Center 261QC1500X
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

3301 Belair Rd Ste 2
Baltimore, MD 21213-1257

Mailing address

3301 Belair Rd Ste 2
Baltimore, MD 21213-1257
Phone (443) 873-7193

Other practice location 1

829 Brightseat Road
Landover, MD 20785
Phone (301) 368-6850

Other identifiers 1

IdentifierTypeStateIssuer
1104326487MedicaidMD

Other names 1

  • Next Step Treatment Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Epiphany Family Services-MD12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

Organizations that report the same tax identification number in the 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.

NPI Registry JSON

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

{
    "created_epoch": "1568160000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701043200000",
    "number": "1093364077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3301 BELAIR RD STE 2",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212131257",
            "telephone_number": "443-873-7193",
            "fax_number": "410-630-7882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3301 BELAIR RD STE 2",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212131257",
            "telephone_number": "410-873-7193",
            "fax_number": "410-630-7882"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "829 Brightseat Road",
            "address_purpose": "LOCATION",
            "city": "Landover",
            "state": "MD",
            "postal_code": "20785",
            "country_code": "US",
            "telephone_number": "301-368-6850",
            "fax_number": "410-630-7882",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "EPIPHANY FAMILY SERVICES MARYLAND LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-11",
        "last_updated": "2023-11-27",
        "certification_date": "2023-11-20",
        "status": "A",
        "authorized_official_last_name": "ESTREET",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "443-873-7193"
    },
    "taxonomies": [
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1104326487",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Next Step Treatment Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Next Step Treatment Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Nov 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.