NPIMap

Organization Active NPI

Refresh Pain and Wellness, LLC

  • Family Medicine Physician
  • Gwynn Oak, MD
National Provider Identifier
1669095402
Registry record updated May 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
REFRESH PAIN AND WELLNESS, LLC
Practice address
6314 Windsor Mill Rd Ste 100
Gwynn Oak, MD 21207-6078
Phone
(443) 893-3808
Fax
(443) 893-3978
NPI assigned
May 27, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 27, 2020

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

Authorized official

Name
Shada Harris
Title
Executive Director
Phone
(443) 893-3808

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

6314 Windsor Mill Rd Ste 100
Gwynn Oak, MD 21207-6078

Mailing address

6314 Windsor Mill Rd Ste 100
Gwynn Oak, MD 21207-6078
Phone (443) 893-3808

National Provider Directory

National Provider Directory
Tax ID family
Refresh Pain and Wellness LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1590537600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1590537600000",
    "number": "1669095402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6314 WINDSOR MILL RD STE 100",
            "city": "GWYNN OAK",
            "state": "MD",
            "postal_code": "212076078",
            "telephone_number": "443-893-3808",
            "fax_number": "443-893-3978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6314 WINDSOR MILL RD STE 100",
            "city": "GWYNN OAK",
            "state": "MD",
            "postal_code": "212076078",
            "telephone_number": "443-893-3808",
            "fax_number": "443-893-3978"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REFRESH PAIN AND WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-27",
        "last_updated": "2020-05-27",
        "certification_date": "2020-05-27",
        "status": "A",
        "authorized_official_last_name": "HARRIS",
        "authorized_official_first_name": "SHADA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "443-893-3808"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gwynn Oak, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2020; 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.