NPIMap

Organization Active NPI

Bluegrass Mental Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Columbia, MD
National Provider Identifier
1639561384
Registry record updated Jun 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
BLUEGRASS MENTAL HEALTH
Practice address
5840 Banneker Rd
Suite 200
Columbia, MD 21044
Phone
(410) 630-7007
NPI assigned
Mar 4, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2018

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

Authorized official

Name
Dr. Mitchell Vincent Mathis Jr., M.D.
Title
Partner
Phone
(240) 678-6118

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

5840 Banneker Rd
Suite 200
Columbia, MD 21044

Mailing address

5840 Banneker Rd Ste 200
Columbia, MD 21044-3156
Phone (410) 457-3196

National Provider Directory

National Provider Directory

Locations

5840 Banneker Rd
Ste 200
Columbia, MD 21044
Phone (410) 457-3196

Practitioners & affiliated clinicians

Practitioners 4

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": "1425427200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1530230400000",
    "number": "1639561384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5840 BANNEKER RD STE 200",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210443156",
            "telephone_number": "410-457-3196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5840 BANNEKER RD",
            "address_2": "SUITE 200",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "21044",
            "telephone_number": "410-630-7007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUEGRASS MENTAL HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-04",
        "last_updated": "2018-06-29",
        "status": "A",
        "authorized_official_last_name": "MATHIS",
        "authorized_official_first_name": "MITCHELL",
        "authorized_official_middle_name": "VINCENT",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "240-678-6118",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2018; 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.