NPIMap

Organization Active NPI

Novasom Inc.

  • Sleep Disorder Diagnostic Clinic/Center
  • Glen Burnie, MD
National Provider Identifier
1487652053
Registry record updated Nov 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sleep Disorder Diagnostic Clinic/CenterTaxonomy code 261QS1200X
Legal business name
NOVASOM INC.
Practice address
801 Cromwell Park Drive,
Suite 108
Glen Burnie, MD 21061
Phone
(410) 590-0443
Fax
(410) 590-4403
NPI assigned
Jul 8, 2005
Last updated
Nov 4, 2014By the provider in NPPES
Organization subpart
Yes
Parent organization
NOVASOM INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 4, 2014

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

Authorized official

Name
Mr. Gregory John Stokes
Title
President & Coo
Phone
(410) 590-0443

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sleep Disorder Diagnostic Clinic/Center 261QS1200X NU Primary

Addresses

Primary practice location

801 Cromwell Park Drive,
Suite 108
Glen Burnie, MD 21061

Mailing address

801 Cromwell Park Drive,
Suite 108
Glen Burnie, MD 21061
Phone (410) 590-0443

Other identifiers 5

IdentifierTypeStateIssuer
003144987AMedicaidGA
1533877MedicaidTN
421865500MedicaidMD
11051200MedicaidFL
201192900MedicaidIN

National Provider Directory

National Provider Directory
Part of
Sleep Solutions Inc

Locations

Dept CH 17169
Palatine, IL 60055

801 Cromwell Park Dr
Ste 108
Glen Burnie, MD 21061
Phone (410) 590-0443

8028 Ritchie Hwy
Ste 120
Pasadena, MD 21122
Phone (410) 590-0443

Practitioners & affiliated clinicians

Practitioners 3

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": "1120780800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1415059200000",
    "number": "1487652053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 CROMWELL PARK DRIVE,",
            "address_2": "SUITE 108",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "21061",
            "telephone_number": "410-590-0443",
            "fax_number": "410-590-4403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 CROMWELL PARK DRIVE,",
            "address_2": "SUITE 108",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "21061",
            "telephone_number": "410-590-0443",
            "fax_number": "410-590-4403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOVASOM INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NOVASOM INC.",
        "enumeration_date": "2005-07-08",
        "last_updated": "2014-11-04",
        "status": "A",
        "authorized_official_last_name": "STOKES",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "PRESIDENT & COO",
        "authorized_official_telephone_number": "410-590-0443",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QS1200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Sleep Disorder Diagnostic",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003144987A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1533877",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "421865500",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "11051200",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201192900",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Burnie, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2014; 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.