NPIMap

Organization Active NPI

Reaching Your Destiny Wellness Center LLC

  • Primary Care Nurse Practitioner
  • Baltimore, MD
National Provider Identifier
1437911336
Registry record updated Oct 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
Legal business name
REACHING YOUR DESTINY WELLNESS CENTER LLC
Practice address
4327 Harford Rd Ste 2
Baltimore, MD 21214-3184
Phone
(410) 999-9999
NPI assigned
Jan 25, 2024
Last updated
Oct 23, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2024

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

Authorized official

Name
Ms. Delisa ProcksNPI 1417880188
Title
PHD
Phone
(410) 999-9999

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 4

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X NU Primary
Mental Health Counselor 101YM0800X NU
Case Management Registered Nurse 163WC0400X NU
Doula 374J00000X NU

Addresses

Primary practice location

4327 Harford Rd Ste 2
Baltimore, MD 21214-3184

Mailing address

2206 Westfield Ave
Baltimore, MD 21214-1050

National Provider Directory

National Provider Directory

Locations

4327 Harford Rd
Ste 2
Baltimore, MD 21214
Phone (410) 999-9999

Practitioners & affiliated clinicians

Practitioners 1

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": "1706140800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729641600000",
    "number": "1437911336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2206 WESTFIELD AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212141050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4327 HARFORD RD STE 2",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212143184",
            "telephone_number": "410-999-9999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REACHING YOUR DESTINY WELLNESS CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-25",
        "last_updated": "2024-10-23",
        "certification_date": "2024-10-23",
        "status": "A",
        "authorized_official_last_name": "PROCKS",
        "authorized_official_first_name": "DELISA",
        "authorized_official_title_or_position": "PHD",
        "authorized_official_telephone_number": "410-999-9999",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "163WC0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Case Management",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "374J00000X",
            "taxonomy_group": "",
            "desc": "Doula",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Oct 23, 2024; 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.