NPIMap

Organization Active NPI

Walnut Street Community Health Center

  • Public Health Dentistry
  • Hagerstown, MD
National Provider Identifier
1104135268
Registry record updated Jul 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health DentistryTaxonomy code 1223D0001X
License
13994 Issued in MD
Legal business name
WALNUT STREET COMMUNITY HEALTH CENTER
Practice address
201 S Cleveland Ave
Hagerstown, MD 21740-5745
Phone
(301) 745-3777
Fax
(301) 393-3463
NPI assigned
Oct 6, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2020

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

Authorized official

Name
Angela Munson
Title
Office Manager
Phone
(301) 745-3777

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223D0001X 13994 MD Primary

Addresses

Primary practice location

201 S Cleveland Ave
Hagerstown, MD 21740-5745

Mailing address

201 S Cleveland Ave
Hagerstown, MD 21740-5745
Phone (301) 745-3777

National Provider Directory

National Provider Directory
Tax ID family
Walnut St Comm HLTH Ctr Inc7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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": "1286323200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1595376000000",
    "number": "1104135268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 S CLEVELAND AVE",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217405745",
            "telephone_number": "301-745-3777",
            "fax_number": "301-393-3463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 S CLEVELAND AVE",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217405745",
            "telephone_number": "301-745-3777",
            "fax_number": "301-393-3463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALNUT STREET COMMUNITY HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-06",
        "last_updated": "2020-07-22",
        "certification_date": "2020-07-22",
        "status": "A",
        "authorized_official_last_name": "MUNSON",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "301-745-3777"
    },
    "taxonomies": [
        {
            "code": "1223D0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Dental Public Health",
            "state": "MD",
            "license": "13994",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hagerstown, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 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.

Verify at the official NPI Registry.