Organization Active NPI

Icare Healthcare Services

  • Psychiatric/Mental Health Nurse Practitioner
  • Washington, DC
National Provider Identifier
1740998327
Registry record updated Oct 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
ICARE HEALTHCARE SERVICES
Practice address
4645 Nannie Helen Burroughs Ave NE Ste 107
Washington, DC 20019-3622
Phone
(240) 466-2855
NPI assigned
Nov 11, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2024

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

Authorized official

Name
Ruth Williams, NPNPI 1356696231
Title
Owner
Phone
(240) 466-2855

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental Disabilities Clinic/Center 261QD1600X
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

4645 Nannie Helen Burroughs Ave NE Ste 107
Washington, DC 20019-3622

Mailing address

4645 Nannie Helen Burroughs Ave NE Ste 107
Washington, DC 20019-3622
Phone (240) 466-2855

Other practice location 1

10301 Georgia Ave Ste 209
Silver Spring, MD 20902-5020
Phone (240) 466-2855

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241018003832 DC Part B Supplier - Clinic/Group Practice 6103358809 Receives reassigned benefits from 1 practitioner
Practice locations: Washington, DC

National Provider Directory

National Provider Directory
Tax ID family
Icare Healthcare Services2 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.

Locations

4645 Nannie Helen Burroughs Ave NE
Ste 107
Washington, DC 20019
Phone (240) 466-2855

7600 Georgia Ave NW
Ste 207
Washington, DC 20012

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": "1668124800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730246400000",
    "number": "1740998327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4645 NANNIE HELEN BURROUGHS AVE NE STE 107",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200193622",
            "telephone_number": "240-466-2855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4645 NANNIE HELEN BURROUGHS AVE NE STE 107",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200193622",
            "telephone_number": "240-466-2855"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10301 Georgia Ave Ste 209",
            "address_purpose": "LOCATION",
            "city": "Silver Spring",
            "state": "MD",
            "postal_code": "209025020",
            "country_code": "US",
            "telephone_number": "240-466-2855",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ICARE HEALTHCARE SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-11",
        "last_updated": "2024-10-30",
        "certification_date": "2024-10-24",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "RUTH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "240-466-2855",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 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.