NPIMap

Organization Active NPI

Antorian Consulting Services

Doing business as Antorian Health, LLC

  • Family Nurse Practitioner
  • Baltimore, MD
National Provider Identifier
1790156891
Registry record updated Apr 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R154023 Issued in MD
Legal business name
ANTORIAN CONSULTING SERVICES
Doing business as
Antorian Health, LLC
Practice address
7004 Security Blvd # 300-A27
Baltimore, MD 21244-2557
Phone
(410) 246-2830
Fax
(410) 246-2831
NPI assigned
Oct 14, 2015
Last updated
Apr 1, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2024

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

Authorized official

Name
Dr. An'Nita Moore-Hebron, DRNP, FNPBC, PMHNPBCNPI 1336572155
Title
Owner
Phone
(410) 246-2830

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R154023 MD Primary

Addresses

Primary practice location

7004 Security Blvd # 300-A27
Baltimore, MD 21244-2557

Mailing address

3545 Ellicott Mills Dr PMB 204
PMB 204
Ellicott City, MD 21043-4548
Phone (410) 246-2830

Other identifiers 1

IdentifierTypeStateIssuer
429909400MedicaidMD

Other names 1

  • Antorian Health, LLC Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170427000009 MD Part B Supplier - Clinic/Group Practice 8729365812 Receives reassigned benefits from 1 practitioner
Practice locations: Windsor Mill, MD

National Provider Directory

National Provider Directory
Tax ID family
Antorian Health 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

7004 Security Blvd
Ste 300A27
Baltimore, MD 21244

5602 Baltimore National Pike
Catonsville, MD 21228
Phone (443) 722-4055

5602 Baltimore National Pike
Ste 303
Catonsville, MD 21228

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1444780800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711929600000",
    "number": "1790156891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3545 ELLICOTT MILLS DR PMB 204",
            "address_2": "PMB 204",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210434548",
            "telephone_number": "410-246-2830",
            "fax_number": "410-246-2831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7004 SECURITY BLVD # 300-A27",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212442557",
            "telephone_number": "410-246-2830",
            "fax_number": "410-246-2831"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANTORIAN CONSULTING SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-14",
        "last_updated": "2024-04-01",
        "certification_date": "2024-04-01",
        "status": "A",
        "authorized_official_last_name": "MOORE-HEBRON",
        "authorized_official_first_name": "AN'NITA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "410-246-2830",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DRNP, FNPBC, PMHNPBC"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R154023",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "429909400",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Antorian Health, LLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Antorian Health, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 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.