Active NPI
Uncaged Potential LLC
- Clinical Social Worker
- Baltimore, MD
National Provider Identifier
1225754831
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- Legal business name
- UNCAGED POTENTIAL LLC
- Practice address
- 703 Dale Ave
Baltimore, MD 21206 - Phone
- (410) 929-1101
- Fax
- (410) 522-1181
- NPI assigned
- Oct 14, 2022
- 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
- Mr. Jeffrey Aviles
- Title
- Owner
- Phone
- (410) 929-1101
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | Primary |
Addresses
Primary practice location
703 Dale Ave
Baltimore, MD 21206
Mailing address
703 Dale Ave
Baltimore, MD 21206
Phone (410) 929-1101
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MD
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20240514000934 | MD | Part B Supplier - Clinic/Group Practice | 9537500194 |
Receives reassigned benefits from 6 practitioners Practice locations: Baltimore, MD |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 7
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Psychiatric/Mental Health Nurse Practitioner
- Aberdeen, MD
- NPI 1871233270
MD
-
- Social Worker
- Salisbury, MD
- NPI 1508536699
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1665705600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1715212800000",
"number": "1225754831",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "703 DALE AVE",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "21206",
"telephone_number": "410-929-1101",
"fax_number": "410-522-1181"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "703 DALE AVE",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "21206",
"telephone_number": "410-929-1101",
"fax_number": "410-522-1181"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "UNCAGED POTENTIAL LLC",
"organizational_subpart": "NO",
"enumeration_date": "2022-10-14",
"last_updated": "2024-05-09",
"certification_date": "2024-03-12",
"status": "A",
"authorized_official_last_name": "AVILES",
"authorized_official_first_name": "JEFFREY",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "410-929-1101",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Social Worker, Clinical",
"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 May 9, 2024; 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.