Organization Active NPI

Bethel Medical Clinic Chartered

  • Internal Medicine Physician
  • Greenbelt, MD
National Provider Identifier
1174625057
Registry record updated Aug 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
BETHEL MEDICAL CLINIC CHARTERED
Practice address
7325 Hanover Pkwy
Suite a
Greenbelt, MD 20770-3618
Phone
(301) 345-3966
Fax
(301) 982-2937
NPI assigned
Sep 2, 2006
Last updated
Aug 8, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2011

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

Authorized official

Name
Babajide Ayodeji Obadina, M.D.,NPI 1215910054
Title
Medical Director
Phone
(301) 345-3966

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary
Hematology & Oncology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RH0003X

Addresses

Primary practice location

7325 Hanover Pkwy
Suite a
Greenbelt, MD 20770-3618

Mailing address

7325 Hanover Pkwy
Suite a
Greenbelt, MD 20770-3618
Phone (301) 345-3966

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100824000285 DC Part B Supplier - Clinic/Group Practice 1850429275 Receives reassigned benefits from 2 practitioners
Practice locations: Greenbelt, MD

National Provider Directory

National Provider Directory

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": "1157155200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1312761600000",
    "number": "1174625057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7325 HANOVER PKWY",
            "address_2": "SUITE A",
            "city": "GREENBELT",
            "state": "MD",
            "postal_code": "207703618",
            "telephone_number": "301-345-3966",
            "fax_number": "301-982-2937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7325 HANOVER PKWY",
            "address_2": "SUITE A",
            "city": "GREENBELT",
            "state": "MD",
            "postal_code": "207703618",
            "telephone_number": "301-345-3966",
            "fax_number": "301-982-2937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BETHEL MEDICAL CLINIC CHARTERED",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-02",
        "last_updated": "2011-08-08",
        "status": "A",
        "authorized_official_last_name": "OBADINA",
        "authorized_official_first_name": "BABAJIDE",
        "authorized_official_middle_name": "AYODEJI",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "301-345-3966",
        "authorized_official_credential": "M.D.,"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenbelt, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2011; 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.