NPIMap

Organization Active NPI

Juspen Enterprises Incorportated

  • Psychiatry Physician
  • Temple Hills, MD
National Provider Identifier
1154488013
Registry record updated May 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
JUSPEN ENTERPRISES INCORPORTATED
Practice address
4400 Stamp Rd
Suite 314
Temple Hills, MD 20748-6716
Phone
(301) 702-0047
Fax
(301) 702-0841
NPI assigned
Jan 2, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 14, 2008

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

Authorized official

Name
Dr. Spencer F Johnson, M.D.NPI 1063579779
Title
Ceo
Phone
(301) 706-5358

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

4400 Stamp Rd
Suite 314
Temple Hills, MD 20748-6716

Mailing address

11703 Amer CT
Fort Washington, MD 20744-5953
Phone (301) 292-8751

Other identifiers 1

IdentifierTypeStateIssuer
025905700MedicaidDC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041217000624 DC Part B Supplier - Clinic/Group Practice 1052378304 Receives reassigned benefits from 2 practitioners
Practice locations: Camp Springs, MD; Washington, DC

National Provider Directory

National Provider Directory

Locations

4710 Auth Pl
Ste 510
Suitland, MD 20746
Phone (301) 702-0047

4400 Stamp Rd
Ste 314
Temple Hills, MD 20748
Phone (301) 702-0047

Practitioners & affiliated clinicians

Practitioners 9

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

NPI Registry JSON

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

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210723200000",
    "number": "1154488013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11703 AMER CT",
            "city": "FORT WASHINGTON",
            "state": "MD",
            "postal_code": "207445953",
            "telephone_number": "301-292-8751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4400 STAMP RD",
            "address_2": "SUITE 314",
            "city": "TEMPLE HILLS",
            "state": "MD",
            "postal_code": "207486716",
            "telephone_number": "301-702-0047",
            "fax_number": "301-702-0841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JUSPEN ENTERPRISES INCORPORTATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-02",
        "last_updated": "2008-05-14",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "SPENCER",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "301-706-5358",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "025905700",
            "state": "DC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Temple Hills, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2008; 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.