NPIMap

Organization Active NPI

Mary'S Center for Maternal & Child Care

  • Federally Qualified Health Center (FQHC)
  • Washington, DC
National Provider Identifier
1417535121
Registry record updated Sep 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
MARY'S CENTER FOR MATERNAL & CHILD CARE
Practice address
6315 5TH St NW
Washington, DC 20011-1325
Phone
(202) 483-8196
Fax
(202) 483-0302
NPI assigned
Apr 1, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2025

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

Authorized official

Name
Monique Margareta Powell-DavisNPI 1326208265
Title
Chief Medical Officer
Phone
(202) 424-2655

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
Dental Clinic/Center 261QD0000X
Federally Qualified Health Center (FQHC) 261QF0400X Primary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X

Addresses

Primary practice location

6315 5TH St NW
Washington, DC 20011-1325

Mailing address

2333 Ontario Rd NW
Washington, DC 20009-2627
Phone (202) 235-1926

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20211101000488 DC Part A Provider - Federally Qualified Health Center (FQHC) 5092798298 Practice locations: Washington, DC

Federally qualified health center certification: CCN 091875

Legal name
MARYS CENTER FOR MATERNAL AND CHILD CARE INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Oct 12, 2021
Last certification
Oct 12, 2021
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Oct 21, 1988 in DC
Enrollment address
6315 5TH St NW
Washington, DC 20011-1325

Other NPIs with the same Medicare PAC ID 6

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Mary'S Center for Maternal and Child Care21 organizations share this tax ID, including this one

Other organizations with this tax ID 20

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

View all 20

Locations

100 Gallatin St NE
Washington, DC 20011
Phone (202) 545-0515

Ownership & related parties

All disclosed owners & managing parties 5

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Tollie B Elliott Individual Corporate OfficerChief Medical Officer Mar 10, 2015
W-2 Managing EmployeeChief Medical Officer Mar 10, 2015
Stuart Butler Individual Corporate DirectorBoard Member Jan 1, 2019
Maria Gomez Individual 5% Or Greater Direct Ownership InterestPresident Jan 1, 2009 100%
Corporate OfficerChief Executive Officer Jan 1, 2009 100%
W-2 Managing EmployeeChief Executive Officer Jan 1, 2009 100%
Michelle Paguin Klinger Individual Corporate DirectorBoard Member Mar 1, 2019
Jonathan D Blum Individual Corporate DirectorBoard Member Nov 1, 2016

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners 57

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

View all 57

NPI Registry JSON

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

{
    "created_epoch": "1617235200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1759104000000",
    "number": "1417535121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2333 ONTARIO RD NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200092627",
            "telephone_number": "202-235-1926",
            "fax_number": "202-478-1840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6315 5TH ST NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200111325",
            "telephone_number": "202-483-8196",
            "fax_number": "202-483-0302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARY'S CENTER FOR MATERNAL & CHILD CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-01",
        "last_updated": "2025-09-29",
        "certification_date": "2025-09-29",
        "status": "A",
        "authorized_official_last_name": "POWELL-DAVIS",
        "authorized_official_first_name": "MONIQUE",
        "authorized_official_middle_name": "MARGARETA",
        "authorized_official_title_or_position": "CHIEF MEDICAL OFFICER",
        "authorized_official_telephone_number": "202-424-2655"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

Verify at the official NPI Registry.