Organization Active NPI

Goodtime Family Care, P.C.

  • Family Medicine Physician
  • Gwynn Oak, MD
National Provider Identifier
1093926206
Registry record updated Sep 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
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

Updated by the provider on Sep 14, 2024

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)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 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

IdentifierTypeStateIssuer
819601000MedicaidMD

Other names 1

  • Amaris Behavioral Health Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL https://goodtimefamilycare.com/

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200420000975 MD Part B Supplier - Clinic/Group Practice 9537599360 Receives reassigned benefits from 1 practitioner
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Gwynn Oak, MD; Baltimore, MD

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory

Ownership & 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.

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": "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.

Verify at the official NPI Registry.