Organization Active NPI

Berkeley Wellness Associates

  • Health Service Clinic/Center
  • Bowie, MD
National Provider Identifier
1154459949
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
License
02187 Issued in MD
Legal business name
BERKELEY WELLNESS ASSOCIATES
Practice address
3327 Superior LN
Suite 204
Bowie, MD 20715-1922
Phone
(301) 860-0288
NPI assigned
Mar 1, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Glenn Bradford Berkeley, D.CNPI 1568599751
Title
Ceo
Phone
(240) 476-5684

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X 02187 MD Primary

Addresses

Primary practice location

3327 Superior LN
Suite 204
Bowie, MD 20715-1922

Mailing address

1922 Cambridge Dr
Crofton, MD 21114-1908
Phone (410) 721-2714

National Provider Directory

National Provider Directory

Locations

3327 Superior Ln
Ste 204
Bowie, MD 20715
Phone (301) 352-6200

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1154459949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1922 CAMBRIDGE DR",
            "city": "CROFTON",
            "state": "MD",
            "postal_code": "211141908",
            "telephone_number": "410-721-2714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3327 SUPERIOR LN",
            "address_2": "SUITE 204",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207151922",
            "telephone_number": "301-860-0288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BERKELEY WELLNESS ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BERKELEY",
        "authorized_official_first_name": "GLENN",
        "authorized_official_middle_name": "BRADFORD",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "240-476-5684",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "MD",
            "license": "02187",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bowie, MD

Sources for this page

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