Active NPI
Taelon Minshik Um
- Clinical Social Worker
- Nottingham, MD
National Provider Identifier
1396489233
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- Practice address
- 5022 Campbell Blvd # 4969
Nottingham, MD 21236-4969 - Phone
- (443) 442-1568
- NPI assigned
- Apr 26, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | Primary |
Addresses
Primary practice location
5022 Campbell Blvd # 4969
Nottingham, MD 21236-4969
Mailing address
8928 Ricky Trevor Rd
Perry Hall, MD 21128-9820
Phone (443) 240-1454
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1650931200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1650931200000",
"number": "1396489233",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8928 RICKY TREVOR RD",
"city": "PERRY HALL",
"state": "MD",
"postal_code": "211289820",
"telephone_number": "443-240-1454"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5022 CAMPBELL BLVD # 4969",
"city": "NOTTINGHAM",
"state": "MD",
"postal_code": "212364969",
"telephone_number": "443-442-1568"
}
],
"practiceLocations": [],
"basic": {
"last_name": "UM",
"first_name": "TAELON",
"middle_name": "MINSHIK",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-04-26",
"last_updated": "2022-04-26",
"certification_date": "2022-04-26",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Nottingham, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.