NPIMap

Organization Active NPI

Coppin State University

Doing business as CSU Community Health Center

  • Primary Care Clinic/Center
  • Baltimore, MD
National Provider Identifier
1427244706
Registry record updated Feb 22, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
COPPIN STATE UNIVERSITY
Doing business as
CSU Community Health Center
Practice address
2500 W North Ave
Suite 131
Baltimore, MD 21216-3633
Phone
(410) 951-4188
NPI assigned
Sep 19, 2007
Last updated
Feb 22, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2013

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

Authorized official

Name
Mrs. Shavon T. Legette, CRNP
Title
Associate Director
Phone
(410) 951-4188

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X
Primary Care Clinic/Center 261QP2300X MD Primary

Addresses

Primary practice location

2500 W North Ave
Suite 131
Baltimore, MD 21216-3633

Mailing address

2601 W. North Avenue
Suite 131
Baltimore, MD 21216
Phone (410) 951-4188

Other identifiers 2

IdentifierTypeStateIssuer
216500700MedicaidMD
216200700MedicaidMD

Other names 1

  • CSU Community Health Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
University of Maryland Athletics-College Park83 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

2500 W North Ave
Ste 131
Baltimore, MD 21216
Phone (410) 951-4188

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1190160000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1361491200000",
    "number": "1427244706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2601 W. NORTH AVENUE",
            "address_2": "SUITE 131",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "21216",
            "telephone_number": "410-951-4188",
            "fax_number": "410-951-6158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 W NORTH AVE",
            "address_2": "SUITE 131",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212163633",
            "telephone_number": "410-951-4188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COPPIN STATE UNIVERSITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-19",
        "last_updated": "2013-02-22",
        "status": "A",
        "authorized_official_last_name": "LEGETTE",
        "authorized_official_first_name": "SHAVON",
        "authorized_official_middle_name": "T.",
        "authorized_official_title_or_position": "ASSOCIATE DIRECTOR",
        "authorized_official_telephone_number": "410-951-4188",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "CRNP"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "MD",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "216500700",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "216200700",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CSU Community Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Feb 22, 2013; 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.