Outreach MD LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

OUTREACH MD LLC

Practice address

4201 Northview Dr
Suite 501
Bowie, MD 20716-2604

Phone

(410) 220-1111

NPI assigned

Apr 26, 2016

Last updated

Aug 18, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Ehsan Abdeshahian, M.D.NPI 1871844720

Title

Medical Director

Phone

(405) 306-0384

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Ehsan Abdeshahian, MD

  • Physical Medicine & Rehabilitation Physician
  • New York, NY
  • NPI 1871844720
  Authorized official Same address or phone

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

{
    "created_epoch": "1461628800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1471478400000",
    "number": "1235584384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2124 4TH AVE S",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352332204",
            "telephone_number": "205-279-8981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4201 NORTHVIEW DR",
            "address_2": "SUITE 501",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207162604",
            "telephone_number": "410-220-1111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OUTREACH MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-26",
        "last_updated": "2016-08-18",
        "status": "A",
        "authorized_official_last_name": "ABDESHAHIAN",
        "authorized_official_first_name": "EHSAN",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "405-306-0384",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0714704",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mauryn Otaren
• Wael Othman, M.D.
• Quilla Otto-Jacobs, LMSW
• Nonyelum Comfort Otuonye
• Brell C Ouafo
• Outreach Recovery II, LLC
• Lindsey L Owens, FNP-C
• Shaun Owens, PT, DPT
• Bolatito A Owolabi
• Lillian Owunnah Njemanze

• Clinic/Center in Bowie, MD
• Providers in Bowie, MD by specialty
• Clinic/Center in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2016; 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.