NPIMap

Organization Active NPI

Holistic Health and Wellness LLC

  • Multi-Specialty Clinic/Center
  • Baltimore, MD
National Provider Identifier
1396355129
Registry record updated May 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
HOLISTIC HEALTH AND WELLNESS LLC
Practice address
1105 N Point Blvd Ste 321
Baltimore, MD 21224-3472
Phone
(410) 517-7060
Fax
(443) 407-2942
NPI assigned
Aug 6, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 25, 2022

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

Authorized official

Name
Michelle Blackston, CRNPNPI 1194277152
Title
Owner/Director
Phone
(410) 517-7060

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
Multi-Specialty Clinic/Center 261QM1300X Primary

Addresses

Primary practice location

1105 N Point Blvd Ste 321
Baltimore, MD 21224-3472

Mailing address

1105 N Point Blvd Ste 321
Baltimore, MD 21224-3472
Phone (410) 517-7060

Other names 1

  • Holistic Health Services, LLC Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20211022000386 MD Part B Supplier - Clinic/Group Practice 3476941592 Receives reassigned benefits from 6 practitioners
Practice locations: Baltimore, MD

National Provider Directory

National Provider Directory
Tax ID family
Holistic Health and Wellness LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Practitioners & affiliated clinicians

Practitioners 6

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": "1596672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1653436800000",
    "number": "1396355129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1105 N POINT BLVD STE 321",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212243472",
            "telephone_number": "410-517-7060",
            "fax_number": "443-407-2942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1105 N POINT BLVD STE 321",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212243472",
            "telephone_number": "410-517-7060",
            "fax_number": "443-407-2942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLISTIC HEALTH AND WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-06",
        "last_updated": "2022-05-25",
        "certification_date": "2022-05-25",
        "status": "A",
        "authorized_official_last_name": "BLACKSTON",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "OWNER/DIRECTOR",
        "authorized_official_telephone_number": "410-517-7060",
        "authorized_official_credential": "CRNP"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Holistic Health Services, LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Holistic Health Services, LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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 May 25, 2022; 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.