NPIMap

Organization Active NPI

Prestige Healthcare Resources Inc.

  • Addiction (Substance Use Disorder) Counselor
  • Largo, MD
National Provider Identifier
1326615089
Registry record updated Feb 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
Legal business name
PRESTIGE HEALTHCARE RESOURCES INC.
Practice address
9500 Medical Center Dr Ste 104
Largo, MD 20774-3703
Phone
(240) 644-3578
NPI assigned
Jun 9, 2021
Last updated
Feb 20, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2022

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

Authorized official

Name
John Saye Smith Jr., BSN
Title
Ceo
Phone
(240) 644-3578

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X Primary

Addresses

Primary practice location

9500 Medical Center Dr Ste 104
Largo, MD 20774-3703

Mailing address

6011 Emerson St Apt 209
Bladensburg, MD 20710-1829
Phone (240) 644-3578

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180717000081 DC Part B Supplier - Clinic/Group Practice 0547493959 Receives reassigned benefits from 8 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Largo, MD; Washington, DC

Other NPIs on the same Medicare enrollment 3

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

National Provider Directory

National Provider Directory
Tax ID family
Prestige Healthcare Resources Inc11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

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

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.

NPI Registry JSON

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

{
    "created_epoch": "1623196800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1645315200000",
    "number": "1326615089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6011 EMERSON ST APT 209",
            "city": "BLADENSBURG",
            "state": "MD",
            "postal_code": "207101829",
            "telephone_number": "240-644-3578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9500 MEDICAL CENTER DR STE 104",
            "city": "LARGO",
            "state": "MD",
            "postal_code": "207743703",
            "telephone_number": "240-644-3578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRESTIGE HEALTHCARE RESOURCES INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-09",
        "last_updated": "2022-02-20",
        "certification_date": "2022-02-20",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "SAYE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "240-644-3578",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "BSN"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Largo, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2022; 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.