NPIMap

Organization Active NPI

Luminis Health Medical Group, LLC

  • Midwife
  • Bowie, MD
National Provider Identifier
1639655913
Registry record updated May 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
MidwifeTaxonomy code 176B00000X
Legal business name
LUMINIS HEALTH MEDICAL GROUP, LLC
Practice address
4175 N Hanson CT
Bowie, MD 20716
Phone
(301) 352-4007
Fax
(301) 352-3316
NPI assigned
Jul 19, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 24, 2021

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

Authorized official

Name
Jeannette Wood
Title
Reimbursement Administrator
Phone
(443) 481-6521

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
MidwifeGroup: 193400000X SINGLE SPECIALTY GROUP 176B00000X MD Primary

Addresses

Primary practice location

4175 N Hanson CT
Bowie, MD 20716

Mailing address

201 Defense Hwy Ste 150
Annapolis, MD 21401-8953
Phone (144) 348-1531

Other identifiers 1

IdentifierTypeStateIssuer
Y88800OtherMDCAREFIRST

Other names 1

  • Premier Ob/Gyn Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Anne Arundel Phys Group LLC221 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1531958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621814400000",
    "number": "1639655913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 DEFENSE HWY STE 150",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214018953",
            "telephone_number": "144-348-1531",
            "fax_number": "443-481-6515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4175 N HANSON CT",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "20716",
            "telephone_number": "301-352-4007",
            "fax_number": "301-352-3316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUMINIS HEALTH MEDICAL GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-19",
        "last_updated": "2021-05-24",
        "certification_date": "2021-05-24",
        "status": "A",
        "authorized_official_last_name": "WOOD",
        "authorized_official_first_name": "JEANNETTE",
        "authorized_official_title_or_position": "REIMBURSEMENT ADMINISTRATOR",
        "authorized_official_telephone_number": "443-481-6521"
    },
    "taxonomies": [
        {
            "code": "176B00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Midwife",
            "state": "MD",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST",
            "identifier": "Y88800",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Premier Ob/Gyn",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bowie, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2021; 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.