NPIMap

Organization Active NPI

Worthington Assisted Living

  • Assisted Living Facility
  • Reisterstown, MD
National Provider Identifier
1770624272
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
Legal business name
WORTHINGTON ASSISTED LIVING
Practice address
64 Main St
Reisterstown, MD 21136-1210
Phone
(410) 526-2146
Fax
(410) 526-7646
NPI assigned
Feb 9, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Joseph Edward Devadoss
Title
Owner
Phone
(410) 298-9800

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X Primary

Addresses

Primary practice location

64 Main St
Reisterstown, MD 21136-1210

Mailing address

6401 Dogwood Rd Ste 108
Baltimore, MD 21207-5248
Phone (410) 298-9800

Other names 1

  • 64 Riesterstown Road LLC Doing business as

National Provider Directory

National Provider Directory

Locations

64 Main St
Reisterstown, MD 21136
Phone (410) 526-2146

NPI Registry JSON

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

{
    "created_epoch": "1170979200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1770624272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6401 DOGWOOD RD STE 108",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212075248",
            "telephone_number": "410-298-9800",
            "fax_number": "410-298-5206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "64 MAIN ST",
            "city": "REISTERSTOWN",
            "state": "MD",
            "postal_code": "211361210",
            "telephone_number": "410-526-2146",
            "fax_number": "410-526-7646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WORTHINGTON ASSISTED LIVING",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DEVADOSS",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "EDWARD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "410-298-9800",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "64 Riesterstown Road LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Reisterstown, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.