NPIMap

Organization Active NPI

Trinity Detox and Family Clinic Inc

  • Family Nurse Practitioner
  • Rosedale, MD
National Provider Identifier
1295386233
Registry record updated Nov 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
TRINITY DETOX AND FAMILY CLINIC INC
Practice address
1232 Race Rd Ste 302
Rosedale, MD 21237-2382
Phone
(443) 326-0503
NPI assigned
Sep 20, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2025

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

Authorized official

Name
Ifeyinwa Cordelia Ibeanu, FNP-BCNPI 1902351430
Title
Family Nurse Practitioner/Provider
Phone
(443) 326-0503

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X Primary

Addresses

Primary practice location

1232 Race Rd Ste 302
Rosedale, MD 21237-2382

Mailing address

1232 Race Rd Ste 302
Rosedale, MD 21237-2382
Phone (443) 326-0503

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20191009002648 MD Part B Supplier - Clinic/Group Practice 4789915521 Receives reassigned benefits from 1 practitioner
Practice locations: Rosedale, MD

National Provider Directory

National Provider Directory
Tax ID family
Trinity Detox and Fam Clin2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1568937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1763078400000",
    "number": "1295386233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1232 RACE RD STE 302",
            "city": "ROSEDALE",
            "state": "MD",
            "postal_code": "212372382",
            "telephone_number": "443-326-0503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1232 RACE RD STE 302",
            "city": "ROSEDALE",
            "state": "MD",
            "postal_code": "212372382",
            "telephone_number": "443-326-0503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRINITY DETOX AND FAMILY CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-20",
        "last_updated": "2025-11-14",
        "certification_date": "2025-11-14",
        "status": "A",
        "authorized_official_last_name": "IBEANU",
        "authorized_official_first_name": "IFEYINWA",
        "authorized_official_middle_name": "CORDELIA",
        "authorized_official_title_or_position": "FAMILY NURSE PRACTITIONER/PROVIDER",
        "authorized_official_telephone_number": "443-326-0503",
        "authorized_official_credential": "FNP-BC"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rosedale, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 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.

Verify at the official NPI Registry.