NPIMap

Organization Active NPI

Johns Hopkins University

Doing business as Koinonia Baptist Church

  • Endocrinology, Diabetes & Metabolism Physician
  • Baltimore, MD
National Provider Identifier
1134880404
Registry record updated Jan 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
Legal business name
JOHNS HOPKINS UNIVERSITY
Doing business as
Koinonia Baptist Church
Practice address
5738 Belair Rd
Baltimore, MD 21206-2603
Phone
(410) 426-0288
NPI assigned
Jan 7, 2022
Last updated
Jan 7, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
JOHNS HOPKINS UNIVERSITYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 7, 2022

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

Authorized official

Name
Shavonda L Keating
Title
Director of Provider Enrollment
Phone
(410) 933-6430

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X Primary

Addresses

Primary practice location

5738 Belair Rd
Baltimore, MD 21206-2603

Mailing address

6201 Greenleigh Ave
Middle River, MD 21220-2004

Other names 1

  • Koinonia Baptist Church Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Johns Hop Univ Inter Me440 organizations share this tax ID, including this one
Part of
Johns Hop Univ Inter Me

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

5738 Belair Rd
Baltimore, MD 21206
Phone (410) 426-0288

NPI Registry JSON

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

{
    "created_epoch": "1641513600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1641513600000",
    "number": "1134880404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6201 GREENLEIGH AVE",
            "city": "MIDDLE RIVER",
            "state": "MD",
            "postal_code": "212202004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5738 BELAIR RD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212062603",
            "telephone_number": "410-426-0288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHNS HOPKINS UNIVERSITY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "JOHNS HOPKINS UNIVERSITY",
        "enumeration_date": "2022-01-07",
        "last_updated": "2022-01-07",
        "certification_date": "2022-01-07",
        "status": "A",
        "authorized_official_last_name": "KEATING",
        "authorized_official_first_name": "SHAVONDA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "DIRECTOR OF PROVIDER ENROLLMENT",
        "authorized_official_telephone_number": "410-933-6430"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Koinonia Baptist Church",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jan 7, 2022; 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.