Brilliantminds Psychiatry, LLC

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Legal business name

BRILLIANTMINDS PSYCHIATRY, LLC

Practice address

301 Hospital Dr
Glen Burnie, MD 21061-5803

Phone

(410) 908-4175

Fax

(410) 709-6685

NPI assigned

Apr 8, 2021

Organization subpart

No

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

Authorized official

Name

Bishoy Michael, MD

Title

Member

Phone

(410) 908-4175

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1617840000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1657756800000",
    "number": "1215517982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9091 SNOWDEN RIVER PKWY # 1215",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210461657",
            "telephone_number": "410-908-4175",
            "fax_number": "410-709-6685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 HOSPITAL DR",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210615803",
            "telephone_number": "410-908-4175",
            "fax_number": "410-709-6685"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5201 Great America Pkwy",
            "address_purpose": "LOCATION",
            "city": "Santa Clara",
            "state": "CA",
            "postal_code": "950541122",
            "country_code": "US",
            "telephone_number": "888-684-2779",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BRILLIANTMINDS PSYCHIATRY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-08",
        "last_updated": "2022-07-14",
        "certification_date": "2022-07-06",
        "status": "A",
        "authorized_official_last_name": "MICHAEL",
        "authorized_official_first_name": "BISHOY",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "410-908-4175",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.