Ciwo Healthcare Services

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

CIWO HEALTHCARE SERVICES

Practice address

10100 Balsamwood Dr
Laurel, MD 20708-3152

Phone

(973) 866-7691

NPI assigned

Oct 25, 2023

Organization subpart

No

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

Authorized official

Name

Chioma EjemoleNPI 1700359163

Title

President

Phone

(973) 866-7691

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in DC

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Chioma Ejemole, NP

  • Family Nurse Practitioner
  • Laurel, MD
  • NPI 1700359163

  DC

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1698192000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698192000000",
    "number": "1548032238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10100 BALSAMWOOD DR",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207083152",
            "telephone_number": "973-866-7691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10100 BALSAMWOOD DR",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207083152",
            "telephone_number": "973-866-7691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CIWO HEALTHCARE SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-25",
        "last_updated": "2023-10-25",
        "certification_date": "2023-10-25",
        "status": "A",
        "authorized_official_last_name": "EJEMOLE",
        "authorized_official_first_name": "CHIOMA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "973-866-7691"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yau Huei Jeffrey Chung, MD
• Cibele Lima Raimondo, DDS, LLC
• Ariana Raquel Cisneros
• City Dermatology, LLC
• Civets Services
• Bevin Allison Clare, CNS, RH
• Angelica Noel Clark Brown, MSW
• Minnie Elizabeth Clark-Lamar, CRNA
• Bailey Clark, DPT
• Christopher Clark, CRNA

• Clinic/Center in Laurel, MD
• Providers in Laurel, MD by specialty
• Clinic/Center in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2023; 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.