Active NPI
Marcus A. Patterson
- Community Health Worker
- Waldorf, MD
National Provider Identifier
1497458772
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Health Worker
- Practice address
- 3028 Churchill CT
Waldorf, MD 20602-2528 - Phone
- (240) 254-7702
- NPI assigned
- Mar 24, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Health Worker | 172V00000X | Primary | ||
| Counselor | 101Y00000X | 22500000X-R | DC |
Addresses
Primary practice location
3028 Churchill CT
Waldorf, MD 20602-2528
Mailing address
3028 Churchill CT
Waldorf, MD 20602-2528
Phone (240) 254-7702
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22500000X-R | DC | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1679616000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1699833600000",
"number": "1497458772",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3028 CHURCHILL CT",
"city": "WALDORF",
"state": "MD",
"postal_code": "206022528",
"telephone_number": "240-254-7702"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3028 CHURCHILL CT",
"city": "WALDORF",
"state": "MD",
"postal_code": "206022528",
"telephone_number": "240-254-7702"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PATTERSON",
"first_name": "MARCUS",
"middle_name": "A.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-03-24",
"last_updated": "2023-11-13",
"certification_date": "2023-11-09",
"status": "A"
},
"taxonomies": [
{
"code": "172V00000X",
"taxonomy_group": "",
"desc": "Community Health Worker",
"state": null,
"license": null,
"primary": true
},
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "DC",
"license": "22500000X-R",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Waldorf, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.