NPIMap

Organization Active NPI

Innersourced Solutions, Inc.

  • Case Management Agency
  • Waldorf, MD
National Provider Identifier
1699597989
Registry record updated Oct 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management AgencyTaxonomy code 251B00000X
Legal business name
INNERSOURCED SOLUTIONS, INC.
Practice address
11705 Berry Rd Ste 104
Waldorf, MD 20603-5933
Phone
(240) 207-4513
NPI assigned
Oct 28, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2024

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

Authorized official

Name
Dr. Michelle A Dillard
Title
Ceo
Phone
(240) 207-4513

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X Primary

Addresses

Primary practice location

11705 Berry Rd Ste 104
Waldorf, MD 20603-5933

Mailing address

11705 Berry Rd Ste 104
Waldorf, MD 20603-5933

National Provider Directory

National Provider Directory
Tax ID family
Innersourced Solutions Inc6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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": "1730073600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730073600000",
    "number": "1699597989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11705 BERRY RD STE 104",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206035933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11705 BERRY RD STE 104",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206035933",
            "telephone_number": "240-207-4513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNERSOURCED SOLUTIONS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-28",
        "last_updated": "2024-10-28",
        "certification_date": "2024-10-28",
        "status": "A",
        "authorized_official_last_name": "DILLARD",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "240-207-4513",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waldorf, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2024; 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.