Individual provider Active NPI

Edward Columbus Whitfield Sr., MSW

  • Clinical Social Worker
  • Glen Burnie, MD
National Provider Identifier
1740690973
Registry record updated Apr 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
1419 Madison Park Dr
Glen Burnie
Glen Burnie, MD 21061-5613
Phone
(410) 768-2719
Fax
(410) 424-2983
NPI assigned
Apr 28, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X MD Primary

Addresses

Primary practice location

1419 Madison Park Dr
Glen Burnie
Glen Burnie, MD 21061-5613

Mailing address

1419 Madison Park Dr
Glen Burnie
Glen Burnie, MD 21061-5613
Phone (410) 768-2719

Other identifiers 1

IdentifierTypeStateIssuer
1104983568MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140911000615 MD Practitioner - Clinical Social Worker 4789803487 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2127 W Pratt St
Baltimore, MD 21223-2244
Phone (410) 878-0655

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Redeem Healthcare and Medical Systems 11 Inc CurrentSince Aug 21, 2023 Accepting new patients
Redeem Healthcare and Medical Systems 11 Inc CurrentSince Aug 21, 2023 Accepting new patients

Locations

2127 W Pratt St
Baltimore, MD 21223
Phone (410) 878-0655

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1398643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398643200000",
    "number": "1740690973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1419 MADISON PARK DR",
            "address_2": "GLEN BURNIE",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210615613",
            "telephone_number": "410-768-2719",
            "fax_number": "410-424-2983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1419 MADISON PARK DR",
            "address_2": "GLEN BURNIE",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210615613",
            "telephone_number": "410-768-2719",
            "fax_number": "410-424-2983"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITFIELD",
        "first_name": "EDWARD",
        "middle_name": "COLUMBUS",
        "name_prefix": "Mr.",
        "name_suffix": "Sr.",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-28",
        "last_updated": "2014-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1104983568",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Burnie, MD

Sources for this page

Verify at the official NPI Registry.