NPIMap

Organization Active NPI

Holistic Health & Wellness Medical Spa

  • Pain Medicine Physician
  • Largo, MD
National Provider Identifier
1497287361
Registry record updated Mar 30, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine PhysicianTaxonomy code 208VP0000X
Legal business name
HOLISTIC HEALTH & WELLNESS MEDICAL SPA
Practice address
1450 Mercantile LN
221
Largo, MD 20774-5376
Phone
(301) 772-1500
Fax
(301) 773-0050
NPI assigned
Mar 30, 2017
Last updated
Mar 30, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2017

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

Authorized official

Name
Ms. Joyce Shawanda Edwards, OWNER
Title
Owner
Phone
(301) 772-1500

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208VP0000X Primary
Geriatric Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 2251G0304X
Massage TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225700000X
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X

Addresses

Primary practice location

1450 Mercantile LN
221
Largo, MD 20774-5376

Mailing address

1450 Mercantile LN
221
Largo, MD 20774-5376
Phone (301) 772-1500

National Provider Directory

National Provider Directory
Tax ID family
Holistic Health and Wellness Medical Spa2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

1450 Mercantile Ln
#221
Largo, MD 20774
Phone (301) 772-1500

NPI Registry JSON

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

{
    "created_epoch": "1490832000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1490832000000",
    "number": "1497287361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1450 MERCANTILE LN",
            "address_2": "221",
            "city": "LARGO",
            "state": "MD",
            "postal_code": "207745376",
            "telephone_number": "301-772-1500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1450 MERCANTILE LN",
            "address_2": "221",
            "city": "LARGO",
            "state": "MD",
            "postal_code": "207745376",
            "telephone_number": "301-772-1500",
            "fax_number": "301-773-0050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLISTIC HEALTH & WELLNESS MEDICAL SPA",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-30",
        "last_updated": "2017-03-30",
        "status": "A",
        "authorized_official_last_name": "EDWARDS",
        "authorized_official_first_name": "JOYCE",
        "authorized_official_middle_name": "SHAWANDA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "301-772-1500",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "OWNER"
    },
    "taxonomies": [
        {
            "code": "208VP0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2251G0304X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Geriatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Massage Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Largo, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2017; 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.