NPIMap

Organization Active NPI

Complete Healthcare, LLC

  • Pediatrics Physician
  • Linthicum, MD
National Provider Identifier
1497955967
Registry record updated Jun 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
D0061341 Issued in MD
Legal business name
COMPLETE HEALTHCARE, LLC
Practice address
809 N Hammonds Ferry Rd Ste C
Linthicum, MD 21090-1317
Phone
(301) 512-8430
Fax
(410) 789-2501
NPI assigned
Jul 23, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2020

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

Authorized official

Name
Johnson Olayinka Johnson, M.D.
Title
Physician
Phone
(410) 789-2500

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X D0061341 MD
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X D0061341 MD Primary
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X D0055180 MD

Addresses

Primary practice location

809 N Hammonds Ferry Rd Ste C
Linthicum, MD 21090-1317

Mailing address

6489 Marshalee Dr Ste C
Elkridge, MD 21075-6507
Phone (301) 512-8430

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071231000293 MD Part B Supplier - Clinic/Group Practice 2961582101 Receives reassigned benefits from 1 practitioner
Practice locations: Linthicum, MD

National Provider Directory

National Provider Directory

Locations

809 N Hammonds Ferry Rd
Ste C
Linthicum Heights, MD 21090
Phone (410) 789-2500

Practitioners & affiliated clinicians

Practitioners 4

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": "1185148800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1591056000000",
    "number": "1497955967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6489 MARSHALEE DR STE C",
            "city": "ELKRIDGE",
            "state": "MD",
            "postal_code": "210756507",
            "telephone_number": "301-512-8430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "809 N HAMMONDS FERRY RD STE C",
            "city": "LINTHICUM",
            "state": "MD",
            "postal_code": "210901317",
            "telephone_number": "301-512-8430",
            "fax_number": "410-789-2501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPLETE HEALTHCARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-23",
        "last_updated": "2020-06-02",
        "certification_date": "2020-06-02",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "JOHNSON",
        "authorized_official_middle_name": "OLAYINKA",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "410-789-2500",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D0061341",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "MD",
            "license": "D0061341",
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MD",
            "license": "D0055180",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Linthicum, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2020; 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.