Blue Balloon MD LLC

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Legal business name

BLUE BALLOON MD LLC

Practice address

500 Redland CT Ste 102
Owings Mills, MD 21117-3265

Phone

(201) 216-9500

NPI assigned

Dec 8, 2020

Organization subpart

No

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

Authorized official

Name

David Sussman

Title

Coo

Phone

(201) 216-9500

Specialties & licenses 1

Addresses

Tax ID family

Blue Balloon MD LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Blue Balloon MD LLC

  • Psychologist
  • Owings Mills, MD
  • NPI 1386212157
  NPD tax ID
• Blue Balloon MD LLC

  • Occupational Therapist
  • Owings Mills, MD
  • NPI 1629646492
  NPD tax ID

Locations

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

{
    "created_epoch": "1607385600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623801600000",
    "number": "1780280404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 BELGROVE DR",
            "city": "KEARNY",
            "state": "NJ",
            "postal_code": "070321507",
            "telephone_number": "201-216-9500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 REDLAND CT STE 102",
            "city": "OWINGS MILLS",
            "state": "MD",
            "postal_code": "211173265",
            "telephone_number": "201-216-9500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE BALLOON MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-08",
        "last_updated": "2021-06-16",
        "certification_date": "2021-06-16",
        "status": "A",
        "authorized_official_last_name": "SUSSMAN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "201-216-9500"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan Bloom
• Shannon Michelle Blount, CRNP RN
• Blue Balloon Maryland LLC
• Blue Balloon MD LLC
• Blue Balloon MD LLC
• David Body, D.M.D.
• Nevin Body, D.O.
• Bodyfit Wellness LLC
• Alicia Bolden, DPT
• Destynee Bolton

• Behavior Analyst in Owings Mills, MD
• Providers in Owings Mills, MD by specialty
• Behavior Analyst in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 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.