Organization Active NPI

Serene Care Holdings LLC

  • Family Nurse Practitioner
  • Owings Mills, MD
National Provider Identifier
1396350484
Registry record updated Aug 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
SERENE CARE HOLDINGS LLC
Practice address
10806 Reisterstown Rd Ste 1F
Owings Mills, MD 21117-4602
Phone
(410) 204-2866
NPI assigned
Sep 15, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2023

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

Authorized official

Name
Stecy A Ola, FNPNPI 1609204528
Title
President
Phone
(708) 497-0734

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
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X Primary

Addresses

Primary practice location

10806 Reisterstown Rd Ste 1F
Owings Mills, MD 21117-4602

Mailing address

10806 Reisterstown Rd Ste 1F
Owings Mills, MD 21117-4602
Phone (410) 204-2866

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210528001580 MD Part B Supplier - Clinic/Group Practice 5395165468 Receives reassigned benefits from 2 practitioners
1 other NPI on this enrollment
Practice locations: Owings Mills, MD

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

10806 Reisterstown Rd
Ste 1F
Owings Mills, MD 21117
Phone (410) 204-2866

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 2

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": "1600128000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691712000000",
    "number": "1396350484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10806 REISTERSTOWN RD STE 1F",
            "city": "OWINGS MILLS",
            "state": "MD",
            "postal_code": "211174602",
            "telephone_number": "410-204-2866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10806 REISTERSTOWN RD STE 1F",
            "city": "OWINGS MILLS",
            "state": "MD",
            "postal_code": "211174602",
            "telephone_number": "410-204-2866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERENE CARE HOLDINGS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-15",
        "last_updated": "2023-08-11",
        "certification_date": "2023-08-11",
        "status": "A",
        "authorized_official_last_name": "OLA",
        "authorized_official_first_name": "STECY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "708-497-0734",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Owings Mills, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2023; 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.