NPIMap

Organization Active NPI

Desicare LLC

  • Family Medicine Physician
  • Waldorf, MD
National Provider Identifier
1801402656
Registry record updated Dec 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
DESICARE LLC
Practice address
3200 Crain Hwy Ste 300
Waldorf, MD 20603-4843
Phone
(301) 852-4540
Fax
(240) 427-9274
NPI assigned
Sep 17, 2020
Last updated
Dec 14, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2021

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

Authorized official

Name
Cheryl Michele Jones
Title
President/Ceo
Phone
(301) 768-7122

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Non-Surgical Family Planning Clinic/Center 261QF0050X NU
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X NU
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

3200 Crain Hwy Ste 300
Waldorf, MD 20603-4843

Mailing address

4157 Mountain Road
160
Pasadena, MD 21122
Phone (470) 263-0801

Other names 1

  • Desicare LLC Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL Pasadena Direct

National Provider Directory

National Provider Directory

Locations

3200 Crain Hwy
Ste 300
Waldorf, MD 20603
Phone (301) 852-4540

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": "1600300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1639440000000",
    "number": "1801402656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4157 MOUNTAIN ROAD",
            "address_2": "160",
            "city": "PASADENA",
            "state": "MD",
            "postal_code": "21122",
            "telephone_number": "470-263-0801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 CRAIN HWY STE 300",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206034843",
            "telephone_number": "301-852-4540",
            "fax_number": "240-427-9274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DESICARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-17",
        "last_updated": "2021-12-14",
        "certification_date": "2021-12-14",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "CHERYL",
        "authorized_official_middle_name": "MICHELE",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "301-768-7122"
    },
    "taxonomies": [
        {
            "code": "261QF0050X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Family Planning, Non-Surgical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Pasadena",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "useOtherDescription": "Pasadena",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Pasadena",
            "address_1": "7712 West Shore Road",
            "city": "Pasadena",
            "state": "MD",
            "country_code": "US",
            "postal_code": "211221519",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Desicare LLC",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Desicare LLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Waldorf, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 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.