NPIMap

Organization Active NPI

Park West Health System

  • Community Health Clinic/Center
  • Baltimore, MD
National Provider Identifier
1467823773
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health Clinic/CenterTaxonomy code 261QC1500X
Legal business name
PARK WEST HEALTH SYSTEM
Practice address
4151 Park Heights Ave
Baltimore, MD 21215-6730
Phone
(443) 884-7642
Fax
(443) 423-0002
NPI assigned
Oct 13, 2015
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Mrs. Cleo Laverne Edmonds, MS
Title
Project Director
Phone
(443) 884-7642

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Clinic/Center 261QC1500X MD Primary

Addresses

Primary practice location

4151 Park Heights Ave
Baltimore, MD 21215-6730

Mailing address

4151 Park Heights Avenue
Hidden Garden Program
Baltimore, MD 21215
Phone (443) 884-7642

National Provider Directory

National Provider Directory
Tax ID family
Park West Health System3 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 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": "1444694400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1467823773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4151 PARK HEIGHTS AVENUE",
            "address_2": "HIDDEN GARDEN PROGRAM",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "21215",
            "telephone_number": "443-884-7642",
            "fax_number": "443-423-0002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4151 PARK HEIGHTS AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212156730",
            "telephone_number": "443-884-7642",
            "fax_number": "443-423-0002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARK WEST HEALTH SYSTEM",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-13",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "EDMONDS",
        "authorized_official_first_name": "CLEO",
        "authorized_official_middle_name": "LAVERNE",
        "authorized_official_title_or_position": "PROJECT DIRECTOR",
        "authorized_official_telephone_number": "443-884-7642",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MS"
    },
    "taxonomies": [
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": "MD",
            "license": null,
            "primary": true
        }
    ],
    "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 Jul 21, 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.

Verify at the official NPI Registry.