NPIMap

University of Maryland Baltimore

Organization Active NPI Primary Care Clinic/Center · Hyattsville, MD

NPI 1336515519 · NPPES record last updated Aug 11, 2015

Key facts

NPI
1336515519
Entity type
Organization (NPI type 2)
Primary specialty
Primary Care Clinic/Center 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
Organization subpart
No

Authorized official

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

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Corporate family (same tax ID) 24

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

Practitioners 1

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

National Provider Directory

Tax ID family
Howard County Health de (83 organizations share this tax ID)

Locations

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

Specialties & licenses

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

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

  • Governor's Wellmobile Program Other name

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 11, 2015.

{
    "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

All providers in Hyattsville, MD · Primary Care Clinic/Center in Maryland

Sources for this page

Verify at the official NPI Registry.