Change Health Systems, Inc

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

11925 Issued in MD

Legal business name

CHANGE HEALTH SYSTEMS, INC

Practice address

2401 Liberty Heights Ave
Suite 4670
Baltimore, MD 21215-8019

Phone

(410) 233-1088

Fax

(410) 233-1087

NPI assigned

Jan 31, 2007

Organization subpart

No

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

Authorized official

Name

Israel Ojo

Title

Chief Executive Officer

Phone

(410) 233-1088

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MD

Enrollment records 1

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Change Health Systems Inc

  • Community/Behavioral Health Agency
  • Hagerstown, MD
  • NPI 1265761753

  O20090317000486

  Same enrollment
• Change Health Systems, Inc

  • Physical Therapy Clinic/Center
  • Baltimore, MD
  • NPI 1093236200

  O20090317000486

  Same enrollment
• Change Health Systems, Inc

  • Community/Behavioral Health Agency
  • Baltimore, MD
  • NPI 1558414862

  O20090317000486

  Same enrollment
• Change Health Systems, Inc.

  • Community/Behavioral Health Agency
  • Baltimore, MD
  • NPI 1124308002

  O20090317000486

  Same enrollment

Practitioners 4

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

• Lori Ann Close, LCSW-C

  • Clinical Social Worker
  • Frederick, MD
  • NPI 1235535618
  NPD
• Esther Cecelia Estwick, M.D.

  • Psychiatry Physician
  • Lanham, MD
  • NPI 1245449594
  NPD
• Yvonne Etenyi Fomengia, CRNP

  • Family Nurse Practitioner
  • Berlin, MD
  • NPI 1215286810
  NPD
• Valerie Tina Marks, LCSW-C

  • Clinical Social Worker
  • Lutherville, MD
  • NPI 1811148042
  NPD

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

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1300924800000",
    "number": "1750428470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2401 LIBERTY HEIGHTS AVE",
            "address_2": "SUITE 4670",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212158019",
            "telephone_number": "410-233-1088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 LIBERTY HEIGHTS AVE",
            "address_2": "SUITE 4670",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212158019",
            "telephone_number": "410-233-1088",
            "fax_number": "410-233-1087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHANGE HEALTH SYSTEMS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-31",
        "last_updated": "2011-03-24",
        "status": "A",
        "authorized_official_last_name": "OJO",
        "authorized_official_first_name": "ISRAEL",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "410-233-1088"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "MD",
            "license": "11925",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "410166900",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "404096100",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Change Health Systems, Inc
• Change Health Systems, Inc
• Change Health Systems, Inc
• Change Health Systems, Inc
• Change Health Systems, Inc
• Change Health Systems, Inc
• Change Health Systems, Inc.
• Change of Pace Counseling Services LLC
• Change Reaction Baltimore
• Change Treatment LLC (Change Treatment Centers)

• Community/Behavioral Health Agency in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Community/Behavioral Health Agency in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2011; 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.