NPIMap

Organization Active NPI

Whole Body Healthcare, LLC

  • Family Nurse Practitioner
  • Baltimore, MD
National Provider Identifier
1740729482
Registry record updated Feb 14, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
WHOLE BODY HEALTHCARE, LLC
Practice address
3914 Hickory Ave
Baltimore, MD 21211-1834
Phone
(410) 662-4476
Fax
(410) 662-9884
NPI assigned
Feb 14, 2017
Organization subpart
No

Practitioners 16

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 16

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Whole Body Healthcare, LLC3914 Hickory Ave, Baltimore, MD 21211-1834(410) 662-4476 Orthoses: Prefabricated (Non-Custom Fabricated)|Orthoses: Off-The-Shelf Accepts assignmentParticipating since Jul 12, 2017

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20170925002590 MD Part B Supplier - Clinic/Group Practice 7012281348 Receives reassigned benefits from 15 practitioners
Practice locations: Baltimore, MD
O20200520002544 MD DME Supplier - Medical Supply CompanyDME Supplier - Orthotic Personnel 7012281348 Practice locations: Baltimore, MD

National Provider Directory

National Provider Directory

NPPES NPI Registry

Updated by the provider on Feb 14, 2017

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

Authorized official

Name
Michael A. Dorn Jr., DCNPI 1467460394
Title
Owner
Phone
(410) 916-6888

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X Primary

Addresses

Primary practice location

3914 Hickory Ave
Baltimore, MD 21211-1834

Mailing address

3914 Hickory Ave
Baltimore, MD 21211-1834
Phone (410) 662-4476

NPI Registry JSON

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

{
    "created_epoch": "1487030400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487030400000",
    "number": "1740729482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3914 HICKORY AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212111834",
            "telephone_number": "410-662-4476",
            "fax_number": "410-662-9884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3914 HICKORY AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212111834",
            "telephone_number": "410-662-4476",
            "fax_number": "410-662-9884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WHOLE BODY HEALTHCARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-14",
        "last_updated": "2017-02-14",
        "status": "A",
        "authorized_official_last_name": "DORN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "410-916-6888",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.