Active NPI
Goodtime Family Care, P.C.
- Family Medicine Physician
- Gwynn Oak, MD
National Provider Identifier
1093926206
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- Legal business name
- GOODTIME FAMILY CARE, P.C.
- Practice address
- 7131 Liberty Rd Ste 103
Gwynn Oak, MD 21207-4580 - Phone
- (410) 325-5700
- Fax
- (410) 325-5765
- NPI assigned
- May 28, 2007
- 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
- Ronda L Herry, CPPM
- Title
- Practice Manager
- Phone
- (410) 325-5700
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | Primary |
Addresses
Primary practice location
7131 Liberty Rd Ste 103
Gwynn Oak, MD 21207-4580
Mailing address
5805 Moravia Rd
Baltimore, MD 21206-6133
Phone (410) 325-5700
Other practice location 1
5805 Moravia Rd
Baltimore, MD 21206-6133
Phone (410) 325-5700
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 819601000 | Medicaid | MD |
Other names 1
- Amaris Behavioral Health
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | https://goodtimefamilycare.com/ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MD
Enrollment records 1
Other NPIs on the same Medicare enrollment 1
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
-
- Psychiatric/Mental Health Nurse Practitioner
- Gwynn Oak, MD
- NPI 1295562395
O20200420000975
National Provider Directory
National Provider DirectoryOwnership & related parties
Subparts reporting this organization as parent 1
Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.
-
- Family Medicine Physician
- Baltimore, MD
- NPI 1851272488
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Family Nurse Practitioner
- Gwynn Oak, MD
- NPI 1942958947
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1180310400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1726272000000",
"number": "1093926206",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5805 MORAVIA RD",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212066133",
"telephone_number": "410-325-5700"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7131 LIBERTY RD STE 103",
"city": "GWYNN OAK",
"state": "MD",
"postal_code": "212074580",
"telephone_number": "410-325-5700",
"fax_number": "410-325-5765"
}
],
"practiceLocations": [
{
"address_1": "5805 Moravia Rd",
"address_purpose": "LOCATION",
"city": "Baltimore",
"state": "MD",
"postal_code": "212066133",
"country_code": "US",
"telephone_number": "410-325-5700",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "GOODTIME FAMILY CARE, P.C.",
"organizational_subpart": "NO",
"enumeration_date": "2007-05-28",
"last_updated": "2024-09-14",
"certification_date": "2024-09-14",
"status": "A",
"authorized_official_last_name": "HERRY",
"authorized_official_first_name": "RONDA",
"authorized_official_middle_name": "L",
"authorized_official_title_or_position": "PRACTICE MANAGER",
"authorized_official_telephone_number": "410-325-5700",
"authorized_official_credential": "CPPM"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Family Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "819601000",
"state": "MD"
}
],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "https://goodtimefamilycare.com/",
"affiliation": "N",
"address_1": "7131 Liberty Rd Ste 103",
"city": "Gwynn Oak",
"state": "MD",
"country_code": "US",
"postal_code": "212074580",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"organization_name": "Amaris Behavioral Health",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Gwynn Oak, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2024; 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.