Organization Active NPI

St. Agnes Home Care

  • Home Health Agency
  • Baltimore, MD
National Provider Identifier
1366442089
Registry record updated Feb 22, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
HH7036R Issued in MD
Legal business name
ST. AGNES HOME CARE
Practice address
1501 S Edgewood St
Suite a
Baltimore, MD 21227-1071
Phone
(410) 368-2825
Fax
(410) 368-8449
NPI assigned
Jul 22, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2012

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

Authorized official

Name
Mr. Brian Clemens
Title
VP of Finance
Phone
(703) 752-8700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X HH7036R MD Primary

Addresses

Primary practice location

1501 S Edgewood St
Suite a
Baltimore, MD 21227-1071

Mailing address

1501 S Edgewood St
Suite a
Baltimore, MD 21227-1071
Phone (410) 368-2825

Other identifiers 1

IdentifierTypeStateIssuer
046033800MedicaidMD

National Provider Directory

National Provider Directory
Tax ID family
Seton Medical Group41 organizations share this tax ID, including this one

Other organizations with this tax ID 40

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

View all 40

Locations

1501 S Edgewood St
Ste A
Halethorpe, MD 21227
Phone (410) 368-2825

NPI Registry JSON

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

{
    "created_epoch": "1121990400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1329868800000",
    "number": "1366442089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 S EDGEWOOD ST",
            "address_2": "SUITE A",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212271071",
            "telephone_number": "410-368-2825",
            "fax_number": "410-368-8449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 S EDGEWOOD ST",
            "address_2": "SUITE A",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212271071",
            "telephone_number": "410-368-2825",
            "fax_number": "410-368-8449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. AGNES HOME CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-22",
        "last_updated": "2012-02-22",
        "status": "A",
        "authorized_official_last_name": "CLEMENS",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "VP OF FINANCE",
        "authorized_official_telephone_number": "703-752-8700",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "MD",
            "license": "HH7036R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "046033800",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2012; 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.