St. Agnes Healthcare, Inc.

Primary specialty

Obesity and Weight Management Nutrition Registered DietitianTaxonomy code 133VN1201X

Legal business name

ST. AGNES HEALTHCARE, INC.

Practice address

900 Caton Ave
Baltimore, MD 21229-5201

Phone

(667) 234-3244

NPI assigned

Oct 4, 2019

Organization subpart

Yes

Parent organization

ST. AGNES HEALTHCARE, INC.As reported in NPPES

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

Authorized official

Name

Edward R Lovern

Title

President/Ceo

Phone

(667) 234-2105

Specialties & licenses 3

Addresses

Other names 1

• St Agnes Diabetes Prevention Program Other name

Part of

Seton Medical Group

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

{
    "created_epoch": "1570147200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1624406400000",
    "number": "1780225326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3585 WASHINGTON BLVD",
            "city": "HALETHORPE",
            "state": "MD",
            "postal_code": "212271676",
            "telephone_number": "667-234-2149",
            "fax_number": "667-234-8644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 CATON AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212295201",
            "telephone_number": "667-234-3244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. AGNES HEALTHCARE, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ST. AGNES HEALTHCARE, INC.",
        "enumeration_date": "2019-10-04",
        "last_updated": "2021-06-23",
        "certification_date": "2021-06-23",
        "status": "A",
        "authorized_official_last_name": "LOVERN",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "667-234-2105"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "133VN1201X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dietitian, Registered, Nutrition, Obesity and Weight Management",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St Agnes Diabetes Prevention Program",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "St Agnes Diabetes Prevention Program",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• St. Agnes Healthcare, Inc.
• St. Agnes Healthcare, Inc.
• St. Agnes Healthcare, Inc.
• St. Agnes Healthcare, Inc.
• St. Agnes Healthcare, Inc.
• St. Agnes Healthcare, Inc.
• St. Agnes Healthcare, Inc.
• St. Agnes Healthcare, Inc.
• St. Agnes Healthcare, Inc.
• St. Agnes Home Care

• Obesity and Weight Management Nutrition Registered Dietitian in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Obesity and Weight Management Nutrition Registered Dietitian in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2021; 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.