NPIMap

Organization Active NPI

Corehealthpsych

  • Psychiatric/Mental Health Nurse Practitioner
  • Baltimore, MD
National Provider Identifier
1194437830
Registry record updated Nov 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
COREHEALTHPSYCH
Practice address
4807 Bayonne Ave Apt C
Baltimore, MD 21206-7622
Phone
(866) 932-7654
Fax
(470) 826-1824
NPI assigned
Dec 14, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2025

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

Authorized official

Name
Augusta WilliamsNPI 1407402910
Title
Owner
Phone
(866) 932-7654

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
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

4807 Bayonne Ave Apt C
Baltimore, MD 21206-7622

Mailing address

2131 Kingston CT SE Ste 112
Marietta, GA 30067-8929
Phone (866) 932-7654

Other practice location 1

205 Sherwood Rd
Jacksonville, NC 28540-5534
Phone (866) 732-7654

Other practice location 2

2131 Kingston Ct SE Ste 112
Marietta, GA 30067-8929
Phone (866) 932-7654

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, MD, NC3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20230524000127 GA Part B Supplier - Clinic/Group Practice 4880050426 Receives reassigned benefits from 1 practitioner
Practice locations: Marietta, GA
O20240301000231 MD Part B Supplier - Clinic/Group Practice 4880050426 Receives reassigned benefits from 1 practitioner
Practice locations: Baltimore, MD
O20240820003908 NC Part B Supplier - Clinic/Group Practice 4880050426 Receives reassigned benefits from 2 practitioners
Practice locations: Jacksonville, NC

National Provider Directory

National Provider Directory

Locations

2131 Kingston Ct SE
Ste 11
Marietta, GA 30067
Phone (866) 932-7654

2131 Kingston Ct SE
Ste 112
Marietta, GA 30067
Phone (866) 932-7654

Practitioners & affiliated clinicians

Practitioners 2

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": "1670976000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762992000000",
    "number": "1194437830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2131 KINGSTON CT SE STE 112",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300678929",
            "telephone_number": "866-932-7654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4807 BAYONNE AVE APT C",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212067622",
            "telephone_number": "866-932-7654",
            "fax_number": "470-826-1824"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "205 Sherwood Rd",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "NC",
            "postal_code": "285405534",
            "country_code": "US",
            "telephone_number": "866-732-7654",
            "fax_number": "470-826-1824",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2131 Kingston Ct SE Ste 112",
            "address_purpose": "LOCATION",
            "city": "Marietta",
            "state": "GA",
            "postal_code": "300678929",
            "country_code": "US",
            "telephone_number": "866-932-7654",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "COREHEALTHPSYCH",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-14",
        "last_updated": "2025-11-13",
        "certification_date": "2025-11-13",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "AUGUSTA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "866-932-7654"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2025; 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.