Joppa Health Services, Inc.

Primary specialty

Methadone ClinicTaxonomy code 261QM2800X

License

11026 Issued in MD

Legal business name

JOPPA HEALTH SERVICES, INC.

Practice address

623 Pulaski Hwy # a
Joppa, MD 21085-3914

Phone

(410) 538-5809

Fax

(410) 538-4249

NPI assigned

Jan 10, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Brent Garrett Bowman, CAC-AD

Title

Administrative Director

Phone

(410) 259-4985

Specialties & licenses 1

Addresses

Other identifiers 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1319414400000",
    "number": "1619026432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "623 PULASKI HWY # A",
            "city": "JOPPA",
            "state": "MD",
            "postal_code": "210853914",
            "telephone_number": "410-538-5809",
            "fax_number": "410-538-4249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "623 PULASKI HWY # A",
            "city": "JOPPA",
            "state": "MD",
            "postal_code": "210853914",
            "telephone_number": "410-538-5809",
            "fax_number": "410-538-4249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOPPA HEALTH SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-10",
        "last_updated": "2011-10-24",
        "status": "A",
        "authorized_official_last_name": "BOWMAN",
        "authorized_official_first_name": "BRENT",
        "authorized_official_middle_name": "GARRETT",
        "authorized_official_title_or_position": "ADMINISTRATIVE DIRECTOR",
        "authorized_official_telephone_number": "410-259-4985",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CAC-AD"
    },
    "taxonomies": [
        {
            "code": "261QM2800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Methadone",
            "state": "MD",
            "license": "11026",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "026500400",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FDA ID NUMBER",
            "identifier": "MD10077M",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Emmanuel C Iwuoha
• Jennifer Jarest, OTR/L
• Sonia Michele Johnson, LMSW
• Donna Jones, RN
• Jessica Noel Jones, RN
• Joppa Magnolia Volunteer Fire Co. Inc.
• Jada Jordan-Dasilva, LMSW
• Joyce Joyner
• Kids N' Play Occupational Therapy
• Terry King, PT

• All providers in Joppa, MD
• Methadone Clinic in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.