Organization Active NPI

Goodtime Family Care PC

  • Psychiatric/Mental Health Nurse Practitioner
  • Gwynn Oak, MD
National Provider Identifier
1295562395
Registry record updated Feb 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
GOODTIME FAMILY CARE PC
Practice address
7131 Liberty Rd Ste 103
Gwynn Oak, MD 21207-4580
Phone
(410) 325-5700
NPI assigned
Sep 14, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2025

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

Authorized official

Name
Ronda Herry
Title
Physician Assistant/Administrator
Phone
(410) 325-5700

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

7131 Liberty Rd Ste 103
Gwynn Oak, MD 21207-4580

Mailing address

7131 Liberty Rd Ste 103
Gwynn Oak, MD 21207-4580
Phone (410) 325-5700

Other names 1

  • AMARIS BEHAVIORAL HEALTH Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200420000975 MD Part B Supplier - Clinic/Group Practice 9537599360 Receives reassigned benefits from 1 practitioner
1 other NPI on this enrollment
Practice locations: Gwynn Oak, MD; Baltimore, MD

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Goodtime Family Care PC2 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.

Locations

5805 Moravia Rd
Baltimore, MD 21206
Phone (410) 325-5700

7131 Liberty Rd
Ste 103
Gwynn Oak, MD 21207
Phone (410) 298-1515

Practitioners & affiliated clinicians

Practitioners 1

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": "1726272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740009600000",
    "number": "1295562395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7131 LIBERTY RD STE 103",
            "city": "GWYNN OAK",
            "state": "MD",
            "postal_code": "212074580",
            "telephone_number": "410-325-5700",
            "fax_number": "410-325-5765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7131 LIBERTY RD STE 103",
            "city": "GWYNN OAK",
            "state": "MD",
            "postal_code": "212074580",
            "telephone_number": "410-325-5700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOODTIME FAMILY CARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-14",
        "last_updated": "2025-02-20",
        "certification_date": "2025-02-20",
        "status": "A",
        "authorized_official_last_name": "HERRY",
        "authorized_official_first_name": "RONDA",
        "authorized_official_title_or_position": "PHYSICIAN ASSISTANT/ADMINISTRATOR",
        "authorized_official_telephone_number": "410-325-5700"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "AMARIS BEHAVIORAL HEALTH",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Gwynn Oak, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 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.