NPIMap

Organization Active NPI

St. Agnes Healthcare, Inc.

  • Neurology Physician
  • Baltimore, MD
National Provider Identifier
1508686213
Registry record updated Oct 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
Legal business name
ST. AGNES HEALTHCARE, INC.
Practice address
3407 Wilkens Avenue
Suite 430
Baltimore, MD 21229-0001
Phone
(667) 234-8444
NPI assigned
Oct 16, 2024
Organization subpart
Yes
Parent organization
ASCENSION HEALTHAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 31, 2024

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

Authorized official

Name
Mr. William B Higginbotham
Title
President/Ceo
Phone
(667) 234-3162

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084N0400X Primary

Addresses

Primary practice location

3407 Wilkens Avenue
Suite 430
Baltimore, MD 21229-0001

Mailing address

3407 Wilkens Avenue
Suite 430
Baltimore, MD 21229-0001
Phone (667) 234-8444

Other names 1

  • Ascension Saint Agnes Neurology Other name

National Provider Directory

National Provider Directory
Tax ID family
Seton Medical Group41 organizations share this tax ID, including this one
Part of
Ascension Health

Other organizations with this tax ID 40

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

View all 40

NPI Registry JSON

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

{
    "created_epoch": "1729036800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730332800000",
    "number": "1508686213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3407 WILKENS AVENUE",
            "address_2": "SUITE 430",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212290001",
            "telephone_number": "667-234-8444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3407 WILKENS AVENUE",
            "address_2": "SUITE 430",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212290001",
            "telephone_number": "667-234-8444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. AGNES HEALTHCARE, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ASCENSION HEALTH",
        "enumeration_date": "2024-10-16",
        "last_updated": "2024-10-31",
        "certification_date": "2024-10-31",
        "status": "A",
        "authorized_official_last_name": "HIGGINBOTHAM",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "667-234-3162",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ascension Saint Agnes Neurology",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Ascension Saint Agnes Neurology",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2024; 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.