NPIMap

Organization Active NPI

A Clean Start LLC

Doing business as A Clean Start Urgent Care

  • General Practice Physician
  • Pikesville, MD
National Provider Identifier
1194295881
Registry record updated Jan 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
A CLEAN START LLC
Doing business as
A Clean Start Urgent Care
Practice address
3 Greenwood PL Ste 108
Pikesville, MD 21208-2701
Phone
(410) 205-7698
Fax
(443) 450-5937
NPI assigned
Nov 26, 2018
Last updated
Jan 10, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2023

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

Authorized official

Name
Mrs. Anikka Stokes, BS
Title
Ceo
Phone
(443) 516-7160

Specialties & licenses 10

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X NU
Mental Health Counselor 101YM0800X NU
Psychologist 103T00000X NU
Clinical Social Worker 1041C0700X NU
Licensed Practical Nurse 164W00000X NU
Psychiatry Physician 2084P0800X NU
General Practice Physician 208D00000X NU Primary
Urgent Care Clinic/Center 261QU0200X NU
Nurse Practitioner 363L00000X NU
Family Nurse Practitioner 363LF0000X NU

Addresses

Primary practice location

3 Greenwood PL Ste 108
Pikesville, MD 21208-2701

Mailing address

3 Greenwood PL Ste 108
Pikesville, MD 21208-2701
Phone (410) 205-7698

Other names 1

  • A Clean Start Urgent Care Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210520000015 MD Part B Supplier - Clinic/Group Practice 9931508124 Receives reassigned benefits from 2 practitioners
Practice locations: Pikesville, MD

National Provider Directory

National Provider Directory
Tax ID family
A Clean Start LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

3 Greenwood Pl
Ste 108
Pikesville, MD 21208
Phone (410) 205-7698

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 4

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": "1543190400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1673308800000",
    "number": "1194295881",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 GREENWOOD PL STE 108",
            "city": "PIKESVILLE",
            "state": "MD",
            "postal_code": "212082701",
            "telephone_number": "410-205-7698",
            "fax_number": "443-450-5937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 GREENWOOD PL STE 108",
            "city": "PIKESVILLE",
            "state": "MD",
            "postal_code": "212082701",
            "telephone_number": "410-205-7698",
            "fax_number": "443-450-5937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "A CLEAN START LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-26",
        "last_updated": "2023-01-10",
        "certification_date": "2023-01-10",
        "status": "A",
        "authorized_official_last_name": "STOKES",
        "authorized_official_first_name": "ANIKKA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "443-516-7160",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "BS"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "A Clean Start Urgent Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pikesville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2023; 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.