Individual provider Active NPI

Carolyn Peoples, ASSISTED LIVING PROV

  • Assisted Living Facility
  • Baltimore, MD
National Provider Identifier
1235251315
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
30AL2883 Issued in MD
Practice address
2607 Elsinore Ave
Baltimore, MD 21216-2126
Phone
(410) 578-0054
Fax
(410) 521-3546
NPI assigned
Apr 6, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X 30AL2883 MD Primary

Addresses

Primary practice location

2607 Elsinore Ave
Baltimore, MD 21216-2126

Mailing address

4321 Mary Ridge Dr
Randallstown, MD 21133-4302
Phone (410) 496-1550

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
30AL2883MDMDAssisted Living Facility

NPI Registry JSON

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

{
    "created_epoch": "1175817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1235251315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4321 MARY RIDGE DR",
            "city": "RANDALLSTOWN",
            "state": "MD",
            "postal_code": "211334302",
            "telephone_number": "410-496-1550",
            "fax_number": "410-521-3546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2607 ELSINORE AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212162126",
            "telephone_number": "410-578-0054",
            "fax_number": "410-521-3546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEOPLES",
        "first_name": "CAROLYN",
        "credential": "ASSISTED LIVING PROV",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-06",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "MD",
            "license": "30AL2883",
            "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 Jul 9, 2007; 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.