Active NPI
Integrare Health Maryland
- Internal Medicine Physician
- Largo, MD
National Provider Identifier
1194496703
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- Legal business name
- INTEGRARE HEALTH MARYLAND
- Practice address
- 9500 Medical Center Dr Ste 474
Largo, MD 20774-3725 - Phone
- (202) 796-5000
- NPI assigned
- Sep 23, 2021
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Charletta Washington
- Title
- Manager
- Phone
- (202) 412-2730
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Wound Care Registered Nurse | 163WW0000X | |||
| Geriatric Medicine (Family Medicine) Physician | 207QG0300X | |||
| Internal Medicine Physician | 207R00000X | Primary |
Addresses
Primary practice location
9500 Medical Center Dr Ste 474
Largo, MD 20774-3725
Mailing address
9500 Medical Center Dr Ste 104
Largo, MD 20774-3703
Phone (202) 796-5000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in DC
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20220728000923 | DC | Part B Supplier - Clinic/Group Practice | 6204218969 | Practice locations: Largo, MD |
National Provider Directory
National Provider DirectoryLocations
9500 Medical Center Dr
Ste 474
Largo, MD 20774
Phone (202) 796-5000
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Case Manager/Care Coordinator
- Washington, DC
- NPI 1730930173
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1632355200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1748995200000",
"number": "1194496703",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9500 MEDICAL CENTER DR STE 104",
"city": "LARGO",
"state": "MD",
"postal_code": "207743703",
"telephone_number": "202-796-5000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9500 MEDICAL CENTER DR STE 474",
"city": "LARGO",
"state": "MD",
"postal_code": "207743725",
"telephone_number": "202-796-5000"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "INTEGRARE HEALTH MARYLAND",
"organizational_subpart": "NO",
"enumeration_date": "2021-09-23",
"last_updated": "2025-06-04",
"certification_date": "2025-06-04",
"status": "A",
"authorized_official_last_name": "WASHINGTON",
"authorized_official_first_name": "CHARLETTA",
"authorized_official_title_or_position": "MANAGER",
"authorized_official_telephone_number": "202-412-2730"
},
"taxonomies": [
{
"code": "163WW0000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Registered Nurse, Wound Care",
"state": null,
"license": null,
"primary": false
},
{
"code": "207QG0300X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Family Medicine, Geriatric Medicine",
"state": null,
"license": null,
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Largo, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 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.