Active NPI
Chacha Impact Healthcare Service LLC
- Home Health Clinical Nurse Specialist
- Beltsville, MD
National Provider Identifier
1306750013
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Clinical Nurse Specialist
- Legal business name
- CHACHA IMPACT HEALTHCARE SERVICE LLC
- Practice address
- 12811 Innisbrook Dr
Beltsville, MD 20705-1183 - Phone
- (240) 374-3285
- NPI assigned
- Sep 30, 2026
- Last updated
- Sep 30, 2026
- 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
- Naomie Mesidor
- Title
- Regiatered Nurse
- Phone
- (240) 374-3285
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Clinical Nurse Specialist | 364SH0200X | NU | Primary |
Addresses
Primary practice location
12811 Innisbrook Dr
Beltsville, MD 20705-1183
Mailing address
12811 Innisbrook Dr
Beltsville, MD 20705-1183
Phone (240) 374-3285
Practitioners & affiliated clinicians
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.
-
- Registered Nurse
- Beltsville, MD
- NPI 1154006831
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1790726400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1790726400000",
"number": "1306750013",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12811 INNISBROOK DR",
"city": "BELTSVILLE",
"state": "MD",
"postal_code": "207051183",
"telephone_number": "240-374-3285"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12811 INNISBROOK DR",
"city": "BELTSVILLE",
"state": "MD",
"postal_code": "207051183",
"telephone_number": "240-374-3285"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CHACHA IMPACT HEALTHCARE SERVICE LLC",
"organizational_subpart": "NO",
"enumeration_date": "2026-09-30",
"last_updated": "2026-09-30",
"certification_date": "2026-09-30",
"status": "A",
"authorized_official_last_name": "MESIDOR",
"authorized_official_first_name": "NAOMIE",
"authorized_official_title_or_position": "REGIATERED NURSE",
"authorized_official_telephone_number": "240-374-3285"
},
"taxonomies": [
{
"code": "364SH0200X",
"taxonomy_group": "",
"desc": "Clinical Nurse Specialist, Home Health",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Beltsville, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.