NPIMap

Organization Active NPI

Corelife Health Services, Inc.

  • Family Medicine Physician
  • Severna Park, MD
National Provider Identifier
1518339209
Registry record updated Oct 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
D0025782 Issued in MD
Legal business name
CORELIFE HEALTH SERVICES, INC.
Practice address
579 Baltimore Annapolis Blvd
Severna Park, MD 21146-3809
Phone
(410) 975-5447
Fax
(888) 709-8865
NPI assigned
Oct 21, 2015
Last updated
Oct 21, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2020

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

Authorized official

Name
Mr. Stephan R Izzi, MD
Title
Director
Phone
(410) 975-5447

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X D0025782 MD Primary

Addresses

Primary practice location

579 Baltimore Annapolis Blvd
Severna Park, MD 21146-3809

Mailing address

1111 Benfield Blvd Ste 250
Millersville, MD 21108-3005
Phone (443) 679-4309

National Provider Directory

National Provider Directory

Locations

3829 Lorna Rd
Ste 312
Hoover, AL 35244
Phone (205) 451-6192

5022 Campbell Blvd
Ste B
Nottingham, MD 21236
Phone (410) 870-3808

5022 Campbell Blvd
Ste C
Nottingham, MD 21236
Phone (410) 870-3808

5022 Campbell Blvd
Ste Bc
Nottingham, MD 21236
Phone (410) 870-3808

1350 Blair Dr
Odenton, MD 21113
Phone (443) 230-3956

1350 Blair Dr
Ste F
Odenton, MD 21113
Phone (443) 230-3956

11221 Dolfield Blvd
Ste 112113
Owings Mills, MD 21117
Phone (443) 213-8482

821 W Benfield Rd
Ste 5
Severna Park, MD 21146
Phone (410) 991-0044

532 Baltimore Blvd
Ste 101
Westminster, MD 21157
Phone (667) 367-2778

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1445385600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603238400000",
    "number": "1518339209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 BENFIELD BLVD STE 250",
            "city": "MILLERSVILLE",
            "state": "MD",
            "postal_code": "211083005",
            "telephone_number": "443-679-4309",
            "fax_number": "855-772-4748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "579 BALTIMORE ANNAPOLIS BLVD",
            "city": "SEVERNA PARK",
            "state": "MD",
            "postal_code": "211463809",
            "telephone_number": "410-975-5447",
            "fax_number": "888-709-8865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORELIFE HEALTH SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-21",
        "last_updated": "2020-10-21",
        "certification_date": "2020-10-21",
        "status": "A",
        "authorized_official_last_name": "IZZI",
        "authorized_official_first_name": "STEPHAN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "410-975-5447",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "MD",
            "license": "D0025782",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Severna Park, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2020; 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.