NPIMap

Organization Active NPI

Corsica River Mental Health Service, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Cambridge, MD
National Provider Identifier
1154939296
Registry record updated Jul 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
CORSICA RIVER MENTAL HEALTH SERVICE, INC.
Practice address
403 High St
Cambridge, MD 21613-1804
Phone
(443) 225-5780
NPI assigned
Jul 15, 2020
Last updated
Jul 15, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2020

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

Authorized official

Name
Melissa Ann Adkins
Title
Compliance Coordinator
Phone
(410) 758-3050

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

403 High St
Cambridge, MD 21613-1804

Mailing address

120 Banjo LN
Centreville, MD 21617-1002

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101210000133 MD Part B Supplier - Clinic/Group Practice 0941497382 Receives reassigned benefits from 10 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Cambridge, MD; Centreville, MD; Federalsburg, MD

Other NPIs on the same Medicare enrollment 3

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

National Provider Directory

National Provider Directory
Tax ID family
Corsica River Mental Health Service Inc6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

Locations

403 High St
Cambridge, MD 21613
Phone (443) 225-5780

502 Poplar St
Cambridge, MD 21613
Phone (443) 225-5780

Practitioners & affiliated clinicians

Practitioners 10

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": "1594771200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1594771200000",
    "number": "1154939296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 BANJO LN",
            "city": "CENTREVILLE",
            "state": "MD",
            "postal_code": "216171002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "403 HIGH ST",
            "city": "CAMBRIDGE",
            "state": "MD",
            "postal_code": "216131804",
            "telephone_number": "443-225-5780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORSICA RIVER MENTAL HEALTH SERVICE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-15",
        "last_updated": "2020-07-15",
        "certification_date": "2020-07-15",
        "status": "A",
        "authorized_official_last_name": "ADKINS",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "COMPLIANCE COORDINATOR",
        "authorized_official_telephone_number": "410-758-3050"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cambridge, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2020; 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.