NPIMap

Organization Active NPI

Independence Foundation, Inc.

  • Community/Behavioral Health Agency
  • Baltimore, MD
National Provider Identifier
1104298355
Registry record updated Oct 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
1700 Issued in MD
Legal business name
INDEPENDENCE FOUNDATION, INC.
Practice address
13 S. Carrollton Ave
Baltimore, MD 21223
Phone
(443) 204-1134
NPI assigned
Oct 28, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2015

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

Authorized official

Name
Lavon Magruder
Title
Executive Director
Phone
(443) 204-1134

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 1700 MD Primary

Addresses

Primary practice location

13 S. Carrollton Ave
Baltimore, MD 21223

Mailing address

13 S Carrollton Ave
Baltimore, MD 21223-2626
Phone (410) 685-0162

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1445990400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1445990400000",
    "number": "1104298355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13 S CARROLLTON AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212232626",
            "telephone_number": "410-685-0162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13 S. CARROLLTON AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "21223",
            "telephone_number": "443-204-1134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDEPENDENCE FOUNDATION, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-28",
        "last_updated": "2015-10-28",
        "status": "A",
        "authorized_official_last_name": "MAGRUDER",
        "authorized_official_first_name": "LAVON",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "443-204-1134"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "MD",
            "license": "1700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Oct 28, 2015; 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.