NPIMap

Organization Active NPI

Bay Region Psychiatric Services, LLC

  • Psychiatry Physician
  • Baltimore, MD
National Provider Identifier
1568651735
Registry record updated Sep 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
BAY REGION PSYCHIATRIC SERVICES, LLC
Practice address
5024 Campbell Blvd
Suite H
Baltimore, MD 21236-5974
Phone
(410) 931-9280
Fax
(410) 931-6694
NPI assigned
Oct 23, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2008

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

Authorized official

Name
Mrs. Dianne C Denton
Title
Practice Manager
Phone
(410) 931-9280

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

5024 Campbell Blvd
Suite H
Baltimore, MD 21236-5974

Mailing address

5024 Campbell Blvd
Suite H
Baltimore, MD 21236-5974
Phone (410) 931-9280

Other identifiers 2

IdentifierTypeStateIssuer
187250800MedicaidMD
154100500MedicaidMD

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1193097600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1221436800000",
    "number": "1568651735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5024 CAMPBELL BLVD",
            "address_2": "SUITE H",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212365974",
            "telephone_number": "410-931-9280",
            "fax_number": "410-931-6694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5024 CAMPBELL BLVD",
            "address_2": "SUITE H",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212365974",
            "telephone_number": "410-931-9280",
            "fax_number": "410-931-6694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAY REGION PSYCHIATRIC SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-23",
        "last_updated": "2008-09-15",
        "status": "A",
        "authorized_official_last_name": "DENTON",
        "authorized_official_first_name": "DIANNE",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "410-931-9280",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "187250800",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "154100500",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Sep 15, 2008; 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.