Pitstop Healthcare LLC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

PITSTOP HEALTHCARE LLC

Doing business as

Health Travel, Immunizations and Physicals

Practice address

3702 Perry Ave
Kensington, MD 20895-2118

Phone

(410) 870-4847

Fax

(410) 510-1627

NPI assigned

Nov 3, 2018

Organization subpart

No

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

Authorized official

Name

Dr. Latonya Carroll, DNP, APRN

Title

Owner/ Ceo

Phone

(410) 870-4847

Specialties & licenses 1

Addresses

Other names 1

• Health Travel, Immunizations and Physicals Doing business as

Locations

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

{
    "created_epoch": "1541203200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1577232000000",
    "number": "1598233934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3702 PERRY AVE",
            "city": "KENSINGTON",
            "state": "MD",
            "postal_code": "208952118",
            "telephone_number": "410-870-4847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3702 PERRY AVE",
            "city": "KENSINGTON",
            "state": "MD",
            "postal_code": "208952118",
            "telephone_number": "410-870-4847",
            "fax_number": "410-510-1627"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1391 W 5th Ave # 241",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432122902",
            "country_code": "US",
            "telephone_number": "614-569-8940",
            "fax_number": "614-375-4130",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PITSTOP HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-03",
        "last_updated": "2019-12-25",
        "certification_date": "2019-12-25",
        "status": "A",
        "authorized_official_last_name": "CARROLL",
        "authorized_official_first_name": "LATONYA",
        "authorized_official_title_or_position": "OWNER/ CEO",
        "authorized_official_telephone_number": "410-870-4847",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DNP, APRN"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Health Travel, Immunizations and Physicals",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Health Travel, Immunizations and Physicals",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Frayda L Penini, LCSW
• Amy Claire Pennington, CPNP-PC
• Carol Petrovitch, D.D.S.
• William Edward Pickeral Jr., LMSW
• Elisabeth Pickett
• Zachary Platt, CNP
• Gregory Stanleon Pokrywka, M.D. FACP
• Dorothy Polahar, DO
• Akshaya Anil Polekar
• Natali Porta

• General Practice Physician in Kensington, MD
• Providers in Kensington, MD by specialty
• General Practice Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 25, 2019; 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.