NPIMap

Organization Active NPI

Juniper Healthcare LLC

  • Nurse Practitioner
  • Catonsville, MD
National Provider Identifier
1346608171
Registry record updated Feb 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
Legal business name
JUNIPER HEALTHCARE LLC
Practice address
1502 Frederick Rd
Catonsville, MD 21228-5019
Phone
(410) 747-3287
Fax
(410) 465-3716
NPI assigned
Feb 8, 2016
Last updated
Feb 8, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2016

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

Authorized official

Name
Dr. Mitul Dave, MDNPI 1396833604
Title
Director
Phone
(443) 804-4628

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU
Nurse Practitioner 363L00000X NU Primary

Addresses

Primary practice location

1502 Frederick Rd
Catonsville, MD 21228-5019

Mailing address

9055 Chevrolet Dr Ste 103
Ellicott City, MD 21042-4091
Phone (443) 804-4268

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20160323002534 MD Part B Supplier - Clinic/Group Practice 1355648064 Receives reassigned benefits from 18 practitioners
Practice locations: Westminster, MD; Towson, MD; Sykesville, MD; Glen Burnie, MD; Forest Hill, MD; Ellicott City, MD; Edgewater, MD; Catonsville, MD…
O20160606000331 DC Part B Supplier - Clinic/Group Practice 1355648064 Receives reassigned benefits from 17 practitioners
Practice locations: Clinton, MD; Forestville, MD; Fort Washington, MD; Laurel, MD

National Provider Directory

National Provider Directory

Locations

1502 Frederick Rd
Catonsville, MD 21228
Phone (410) 747-0120

9211 Stuart Ln
Clinton, MD 20735
Phone (301) 868-3600

9055 Chevrolet Dr
Ste 103
Ellicott City, MD 21042
Phone (443) 355-6290

12021 Livingston Rd
#C
Fort Washington, MD 20744
Phone (301) 292-0300

Practitioners & affiliated clinicians

Practitioners 21

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.

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1454889600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1454889600000",
    "number": "1346608171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9055 CHEVROLET DR STE 103",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210424091",
            "telephone_number": "443-804-4268",
            "fax_number": "410-465-3716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1502 FREDERICK RD",
            "city": "CATONSVILLE",
            "state": "MD",
            "postal_code": "212285019",
            "telephone_number": "410-747-3287",
            "fax_number": "410-465-3716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JUNIPER HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-08",
        "last_updated": "2016-02-08",
        "status": "A",
        "authorized_official_last_name": "DAVE",
        "authorized_official_first_name": "MITUL",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "443-804-4628",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Catonsville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2016; 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.