NPIMap

Organization Active NPI

Total Image Care, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Bel Air, MD
National Provider Identifier
1104253160
Registry record updated Oct 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
TOTAL IMAGE CARE, INC.
Practice address
500 Upper Chesapeake Dr
Suite 11
Bel Air, MD 21014-4324
Phone
(443) 643-3224
Fax
(443) 643-3227
NPI assigned
Oct 3, 2013
Organization subpart
Yes
Parent organization
TOTAL IMAGE CARE, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 3, 2013

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

Authorized official

Name
Mr. Edward Jerome Kelly III, MBA, CPA
Title
Ceo
Phone
(410) 560-0614

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Primary

Addresses

Primary practice location

500 Upper Chesapeake Dr
Suite 11
Bel Air, MD 21014-4324

Mailing address

1850 York Rd
Suite I
Lutherville, MD 21093-5122
Phone (410) 560-0614

Other identifiers 3

IdentifierTypeStateIssuer
F807OtherMDCAREFIRST BLUE CROSS BLUE SHIELD
6010000800MedicaidMD
MH24OtherMDCAREFIRST BLUE CROSS BLUE SHIELD

Other names 1

  • Image Recovery Center at Upper Chesapeake Doing business as

National Provider Directory

National Provider Directory
Part of
Total Image Care Inc

Locations

401 N Broadway St
#1300
Baltimore, MD 21287
Phone (410) 502-5623

500 Upper Chesapeake Dr
Ste 11
Bel Air, MD 21014
Phone (443) 643-3224

500 Upper Chesapeake Dr
#11
Bel Air, MD 21014
Phone (443) 643-3224

9103 Franklin Square Dr
Ste 1700
Rosedale, MD 21237
Phone (443) 777-6302

1850 York Rd
Ste I
Timonium, MD 21093

NPI Registry JSON

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

{
    "created_epoch": "1380758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1380758400000",
    "number": "1104253160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1850 YORK RD",
            "address_2": "SUITE I",
            "city": "LUTHERVILLE",
            "state": "MD",
            "postal_code": "210935122",
            "telephone_number": "410-560-0614",
            "fax_number": "410-560-0613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 UPPER CHESAPEAKE DR",
            "address_2": "SUITE 11",
            "city": "BEL AIR",
            "state": "MD",
            "postal_code": "210144324",
            "telephone_number": "443-643-3224",
            "fax_number": "443-643-3227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOTAL IMAGE CARE, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "TOTAL IMAGE CARE, INC",
        "enumeration_date": "2013-10-03",
        "last_updated": "2013-10-03",
        "status": "A",
        "authorized_official_last_name": "KELLY",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "JEROME",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "410-560-0614",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "MBA, CPA"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST BLUE CROSS BLUE SHIELD",
            "identifier": "F807",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6010000800",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST BLUE CROSS BLUE SHIELD",
            "identifier": "MH24",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Image Recovery Center at Upper Chesapeake",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bel Air, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2013; 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.