Organization Active NPI

Nourish Care Inc

  • Primary Care Clinic/Center
  • Glendale, CA
National Provider Identifier
1497607964
Registry record updated Feb 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
NOURISH CARE INC
Practice address
204 E Chevy Chase Dr Ste 2
Glendale, CA 91205-3181
Phone
(747) 277-1111
Fax
(747) 277-1112
NPI assigned
Feb 9, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2026

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

Authorized official

Name
Maribeth McKinney, FNPNPI 1578878948
Title
Ceo
Phone
(747) 277-1111

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

204 E Chevy Chase Dr Ste 2
Glendale, CA 91205-3181

Mailing address

204 E Chevy Chase Dr Ste 2
Glendale, CA 91205-3181
Phone (747) 277-1111

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260428000841 CA Part B Supplier - Clinic/Group Practice 9032686035 Receives reassigned benefits from 1 practitioner
Practice locations: Glendale, CA

National Provider Directory

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.

NPI Registry JSON

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

{
    "created_epoch": "1770595200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1770681600000",
    "number": "1497607964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 E CHEVY CHASE DR STE 2",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912053181",
            "telephone_number": "747-277-1111",
            "fax_number": "747-277-1112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 E CHEVY CHASE DR STE 2",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912053181",
            "telephone_number": "747-277-1111",
            "fax_number": "747-277-1112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOURISH CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-02-09",
        "last_updated": "2026-02-10",
        "certification_date": "2026-02-10",
        "status": "A",
        "authorized_official_last_name": "MCKINNEY",
        "authorized_official_first_name": "MARIBETH",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "747-277-1111",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.