NPIMap

Organization Active NPI

Cultivating Change

  • Clinic/Center
  • Baltimore, MD
National Provider Identifier
1093458051
Registry record updated Jun 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
CULTIVATING CHANGE
Doing business as
Cultivating Change
Practice address
2512 N. Charles Street
1St Floor/B
Baltimore, MD 21218-4645
Phone
(410) 493-3372
NPI assigned
Apr 18, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2022

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

Authorized official

Name
Delora Walker
Title
Executive Director
Phone
(410) 493-3372

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

2512 N. Charles Street
1St Floor/B
Baltimore, MD 21218-4645

Mailing address

2512 N. Charles Street
1St Floor/B
Baltimore, MD 21218-4645
Phone (410) 493-3372

Other identifiers 1

IdentifierTypeStateIssuer
1558019489MedicaidMD

Other names 1

  • Cultivating Change Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Cultivating Change4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

2512 N Charles St
Baltimore, MD 21218
Phone (410) 243-0458

NPI Registry JSON

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

{
    "created_epoch": "1650240000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1656374400000",
    "number": "1093458051",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2512 N. CHARLES STREET",
            "address_2": "1ST FLOOR/B",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212184645",
            "telephone_number": "410-493-3372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2512 N. CHARLES STREET",
            "address_2": "1ST FLOOR/B",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212184645",
            "telephone_number": "410-493-3372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CULTIVATING CHANGE",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-18",
        "last_updated": "2022-06-28",
        "certification_date": "2022-06-28",
        "status": "A",
        "authorized_official_last_name": "WALKER",
        "authorized_official_first_name": "DELORA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "410-493-3372"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1558019489",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cultivating Change",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Cultivating Change",
            "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 Jun 28, 2022; 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.