NPIMap

Organization Active NPI

University of Maryland Baltimore

  • Primary Care Clinic/Center
  • Hyattsville, MD
National Provider Identifier
1336515519
Registry record updated Aug 11, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
UNIVERSITY OF MARYLAND BALTIMORE
Practice address
8011 New Hampshire Ave
Mobile Unit
Hyattsville, MD 20783-4612
Phone
(866) 228-9668
Fax
(410) 706-5145
NPI assigned
Aug 11, 2015
Last updated
Aug 11, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2015

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

Authorized official

Name
Ms. Susan Marie Antol, MS, RNNPI 1982918926
Title
Program Director
Phone
(410) 706-5395

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

8011 New Hampshire Ave
Mobile Unit
Hyattsville, MD 20783-4612

Mailing address

655 W Lombard St
Suite 425B
Baltimore, MD 21201-1512
Phone (410) 706-5395

Other names 1

  • Governor's Wellmobile Program Other name

National Provider Directory

National Provider Directory
Tax ID family
Physician Group WPCC83 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

655 W Lombard St
Ste 425B
Baltimore, MD 21201
Phone (410) 706-5145

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": "1439251200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1439251200000",
    "number": "1336515519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "655 W LOMBARD ST",
            "address_2": "SUITE 425B",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212011512",
            "telephone_number": "410-706-5395",
            "fax_number": "410-706-0140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8011 NEW HAMPSHIRE AVE",
            "address_2": "MOBILE UNIT",
            "city": "HYATTSVILLE",
            "state": "MD",
            "postal_code": "207834612",
            "telephone_number": "866-228-9668",
            "fax_number": "410-706-5145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY OF MARYLAND BALTIMORE",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-11",
        "last_updated": "2015-08-11",
        "status": "A",
        "authorized_official_last_name": "ANTOL",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "PROGRAM DIRECTOR",
        "authorized_official_telephone_number": "410-706-5395",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MS, RN"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Governor's Wellmobile Program",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Hyattsville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2015; 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.