NPIMap

Organization Active NPI

Tri-State Health, Inc

  • Psychiatric/Mental Health Nurse Practitioner
  • North East, MD
National Provider Identifier
1386407138
Registry record updated Feb 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
TRI-STATE HEALTH, INC
Practice address
2288 Pulaski Hwy
North East, MD 21901-3702
Phone
(410) 392-6408
NPI assigned
Feb 5, 2024
Organization subpart
Yes
Parent organization
TRI-STATE HEALTH, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 6, 2024

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

Authorized official

Name
Muhammed Arif Niaz, MDNPI 1255338869
Title
Managin Member
Phone
(410) 392-6408

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
Addiction Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RA0401X
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

2288 Pulaski Hwy
North East, MD 21901-3702

Mailing address

107 N Bridge St
Elkton, MD 21921-5326
Phone (410) 392-6408

National Provider Directory

National Provider Directory
Tax ID family
Tri-State Health Inc5 organizations share this tax ID, including this one
Part of
Tri-State Health Inc

Other organizations with this tax ID 4

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

Locations

2527 Jacob Tome Memorial Hwy
Colora, MD 21917
Phone (410) 392-6408

2288 Pulaski Hwy
Ste 1
North East, MD 21901
Phone (410) 392-6408

Practitioners & affiliated clinicians

Practitioners 4

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

NPI Registry JSON

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

{
    "created_epoch": "1707091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707177600000",
    "number": "1386407138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 N BRIDGE ST",
            "city": "ELKTON",
            "state": "MD",
            "postal_code": "219215326",
            "telephone_number": "410-392-6408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2288 PULASKI HWY",
            "city": "NORTH EAST",
            "state": "MD",
            "postal_code": "219013702",
            "telephone_number": "410-392-6408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRI-STATE HEALTH, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "TRI-STATE HEALTH, INC",
        "enumeration_date": "2024-02-05",
        "last_updated": "2024-02-06",
        "certification_date": "2024-02-06",
        "status": "A",
        "authorized_official_last_name": "NIAZ",
        "authorized_official_first_name": "MUHAMMED",
        "authorized_official_middle_name": "ARIF",
        "authorized_official_title_or_position": "MANAGIN MEMBER",
        "authorized_official_telephone_number": "410-392-6408",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RA0401X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Addiction Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North East, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2024; 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.