Mary T Maryland

Primary specialty

Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X

Legal business name

MARY T MARYLAND

Practice address

820 Ritchie Hwy Ste 100
Severna Park, MD 21146-4111

Phone

(410) 544-6813

Fax

(410) 544-6818

NPI assigned

Sep 25, 2009

Last updated

Sep 25, 2009By 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

Connie Winbauer

Title

Controller

Phone

(763) 862-5436

Specialties & licenses 2

Addresses

Other identifiers 1

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

{
    "created_epoch": "1253836800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1253836800000",
    "number": "1629302401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1555 118TH LN NW",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554487579",
            "telephone_number": "763-862-5436",
            "fax_number": "763-754-0332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 RITCHIE HWY STE 100",
            "city": "SEVERNA PARK",
            "state": "MD",
            "postal_code": "211464111",
            "telephone_number": "410-544-6813",
            "fax_number": "410-544-6818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARY T MARYLAND",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-25",
        "last_updated": "2009-09-25",
        "status": "A",
        "authorized_official_last_name": "WINBAUER",
        "authorized_official_first_name": "CONNIE",
        "authorized_official_title_or_position": "CONTROLLER",
        "authorized_official_telephone_number": "763-862-5436"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "MD",
            "license": null,
            "primary": false
        },
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "MD",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "580015300",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Barry Manson, DDS
• Bernadette B. Martin, R.N.
• Donna Marie Martin, RN BSN
• Erica Loller Martin, LCSW-C
• Emma Martinez, COTA
• Maryland Caregivers, LLC (Senior Helpers Annapolis)
• Maryland CVS Pharmacy, L.L.C. (CVS Pharmacy # 03045)
• Maryland Elder Care LLC
• Taylor Ann Mast, LCSW-C
• Paula Mastboom-Bell, P.T.

• Intellectual Disabilities Intermediate Care Facility in Severna Park, MD
• Providers in Severna Park, MD by specialty
• Intellectual Disabilities Intermediate Care Facility in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2009; 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.