Genesis Spa Creek Center

Primary specialty

Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X

License

05390 Issued in MD

Legal business name

GENESIS SPA CREEK CENTER

Practice address

35 Milkshake LN
Annapolis, MD 21403-1507

Phone

(410) 269-5100

NPI assigned

Apr 26, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Kristen Elizabeth Raines, MSCCC-SLP

Title

Speech Pathologist

Phone

(410) 562-0754

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1177545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1548480411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1108 CATTAIL COMMONS WAY",
            "city": "DENTON",
            "state": "MD",
            "postal_code": "216293015",
            "telephone_number": "410-562-0754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 MILKSHAKE LN",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214031507",
            "telephone_number": "410-269-5100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESIS SPA CREEK CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "RAINES",
        "authorized_official_first_name": "KRISTEN",
        "authorized_official_middle_name": "ELIZABETH",
        "authorized_official_title_or_position": "SPEECH PATHOLOGIST",
        "authorized_official_telephone_number": "410-562-0754",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MSCCC-SLP"
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "MD",
            "license": "05390",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Duane M Gels, MD
• Gemini Imaging Group, Inc
• Genesis Health Care
• Genesis Rehabilitation Services
• Genesis Rehabilitation Services
• Ryan Reeder Gens, DDS
• Karen Gentile, CLINICAL SOCIAL WORK
• George B. Shields, O.D., P.C. (Shields Vision)
• Jinu George, PHARMD
• Krysten Leigh George

• Nursing Facility/Intermediate Care Facility in Annapolis, MD
• Providers in Annapolis, MD by specialty
• Nursing Facility/Intermediate Care Facility in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.