NPIMap

Organization Active NPI

Vesta Inc

  • Community/Behavioral Health Agency
  • California, MD
National Provider Identifier
1134419294
Registry record updated Apr 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
5053 Issued in MD
Legal business name
VESTA INC
Practice address
22685 Three Notch Rd Ste 200
California, MD 20619-3152
Phone
(301) 863-4543
Fax
(301) 863-4542
NPI assigned
Apr 11, 2011
Organization subpart
Yes
Parent organization
VESTA, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 27, 2023

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

Authorized official

Name
Ms. Lorena Memberg
Title
Director of Finance
Phone
(240) 296-6333

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 5053 MD Primary

Addresses

Primary practice location

22685 Three Notch Rd Ste 200
California, MD 20619-3152

Mailing address

9301 Annapolis Rd
Suite 300
Lanham, MD 20706-3115
Phone (240) 296-5930

Other identifiers 3

IdentifierTypeStateIssuer
260991610MedicaidMD
949LOtherMDMEDICARE
1134419294MedicaidMD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050411001119 MD Part B Supplier - Clinic/Group Practice 3678568375 Receives reassigned benefits from 20 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Waldorf, MD; Lexington Park, MD; Odenton, MD

Other NPIs on the same Medicare enrollment 2

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

National Provider Directory

National Provider Directory
Tax ID family
VMHC25 organizations share this tax ID, including this one
Part of
VMHC

Other organizations with this tax ID 24

Organizations that report the same tax identification number in the National Provider Directory.

View all 24

Locations

2340 University Blvd E
Adelphi, MD 20783
Phone (301) 445-5775

22685 Three Notch Rd
Ste 200
California, MD 20619
Phone (301) 863-4543

10123 Senate Dr
Fl 1
Lanham, MD 20706
Phone (301) 459-9840

5900 Princess Garden Pkwy
Ste 300
Lanham, MD 20706
Phone (301) 588-8881

9320 Annapolis Rd
Ste 100
Lanham, MD 20706
Phone (301) 577-8152

46940 S Shangri La Dr
Ste 15
Lexington Park, MD 20653
Phone (301) 863-4543

4615 Wheeler Hills Rd
Oxon Hill, MD 20745
Phone (301) 505-1700

Practitioners & affiliated clinicians

Practitioners 27

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1302480000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682553600000",
    "number": "1134419294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9301 ANNAPOLIS RD",
            "address_2": "SUITE 300",
            "city": "LANHAM",
            "state": "MD",
            "postal_code": "207063115",
            "telephone_number": "240-296-5930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22685 THREE NOTCH RD STE 200",
            "city": "CALIFORNIA",
            "state": "MD",
            "postal_code": "206193152",
            "telephone_number": "301-863-4543",
            "fax_number": "301-863-4542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VESTA INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "VESTA, INC.",
        "enumeration_date": "2011-04-11",
        "last_updated": "2023-04-27",
        "certification_date": "2023-04-27",
        "status": "A",
        "authorized_official_last_name": "MEMBERG",
        "authorized_official_first_name": "LORENA",
        "authorized_official_title_or_position": "DIRECTOR OF FINANCE",
        "authorized_official_telephone_number": "240-296-6333",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "MD",
            "license": "5053",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "260991610",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "949L",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1134419294",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in California, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2023; 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.