Organization Active NPI

Serenity Center for Health & Wellness

  • Primary Care Nurse Practitioner
  • Laurel, MD
National Provider Identifier
1659094530
Registry record updated Mar 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
Legal business name
SERENITY CENTER FOR HEALTH & WELLNESS
Practice address
9608 Boundless Shade Ter
Laurel, MD 20723-1490
Phone
(443) 774-8259
Fax
(443) 214-0542
NPI assigned
Sep 26, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2024

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

Authorized official

Name
Jennifer Lee Bryant, FNPNPI 1346819950
Title
FNP-BC
Phone
(443) 774-8259

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X
Primary Care Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP2300X Primary

Addresses

Primary practice location

9608 Boundless Shade Ter
Laurel, MD 20723-1490

Mailing address

9608 Boundless Shade Ter
Laurel, MD 20723-1490
Phone (443) 774-8259

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240319002441 MD Part B Supplier - Clinic/Group Practice 6103263751 Receives reassigned benefits from 1 practitioner
Practice locations: Laurel, MD

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1664150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709510400000",
    "number": "1659094530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9608 BOUNDLESS SHADE TER",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207231490",
            "telephone_number": "443-774-8259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9608 BOUNDLESS SHADE TER",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207231490",
            "telephone_number": "443-774-8259",
            "fax_number": "443-214-0542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERENITY CENTER FOR HEALTH & WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-26",
        "last_updated": "2024-03-04",
        "certification_date": "2024-03-04",
        "status": "A",
        "authorized_official_last_name": "BRYANT",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "FNP-BC",
        "authorized_official_telephone_number": "443-774-8259",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laurel, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.