Total Health Care Inc
Organization Active NPI Federally Qualified Health Center (FQHC) · Baltimore, MD
NPI 1801880315 · NPPES record last updated Oct 17, 2024
Key facts
- NPI
- 1801880315
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Federally Qualified Health Center (FQHC) 261QF0400X
- Legal business name
- TOTAL HEALTH CARE INC
- Practice address
- 2400 Kirk Ave
Baltimore, MD 21218-5507 - Phone
- (410) 383-0083
- Fax
- (410) 383-3160
- NPI assigned
- Sep 12, 2005
- Reactivated
- Feb 7, 2011
- Organization subpart
- No
Authorized official
- Name
- Kevin D Bellamy
- Title
- Ceo
- Phone
- (410) 728-4090
Other NPIs on the same Medicare enrollment 10
Other NPIs with the same Medicare PAC ID 8
Corporate family (same tax ID) 28
Practitioners 64
-
Ugo Sherrin Akara, CRNP
-
Jane Y Choi, DNP
-
Cordell Drummond, LCSW-C
-
Teresa Crenshaw, LICSW, LCSW-C
-
Brice Olivia M Happi, DNP
-
Amy Chesser Lewis, CRNP
-
Victoria Sheree Lyons, MD, MPH
-
Sophia Lynn Robinson, M.D.
-
Jeffrey Howard Adams, LCSW-C
-
Rona Maschonda Adams, PMHNP
-
Rashidat Akinsanya, CRNP-PMH
-
Linda Achiaa Bediako Fosu, AGPCNP
-
Abena Cassell-Swaby, LCSW-C
-
Darrin Coley, LCSW-C
-
Gerrin Davis, NP
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in MD
Federally qualified health center certification: CCN 211858
- Legal name
- TOTAL HEALTH CARE INC
- Certification status
- Active
- Provider type (POS)
- Federally qualified health center
- Participating since
- Mar 30, 2007
- Last certification
- Mar 30, 2007
- Ownership / control type
- For profit – corporation
- Organization structure
- Corporation · Non-profit
- Incorporated
- Jun 19, 1989 in MD
- Enrollment address
- 2400 Kirk Ave
Baltimore, MD 21218-5507
All disclosed owners & managing parties 8
| Name | Role | Since | Share |
|---|---|---|---|
| Gretchen M Spell |
Corporate Officer |
Jan 1, 2023 | |
| Ashley Archie |
Corporate Officer |
Jan 1, 2023 | |
| Donnell Henry |
Corporate Officer |
Jan 1, 2023 | |
| Nichole M Boswell |
Corporate Officer |
Jan 1, 2023 | |
| Kevin D Bellamy |
Corporate Officer |
Jan 1, 2018 | 100% |
| W-2 Managing Employee |
Jan 1, 2018 | 100% | |
| Teneah Lee |
Corporate Officer |
Jan 1, 2023 | |
| H Duante Duckett |
Corporate Officer |
Jan 1, 2023 | |
| Michael Johnson |
Corporate Officer |
Jan 1, 2023 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20070203000128 | MD | Part a Provider - Federally Qualified Health Center (FQHC) | 0446258487 |
1 other NPI on this enrollment Practice locations: Baltimore, MD |
| O20071107000802 | MD | Part B Supplier - Clinic/Group Practice | 0446258487 |
Receives reassigned benefits from 107 practitioners 10 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Odenton, MD; Brooklyn, MD; Baltimore, MD |
National Provider Directory
- Tax ID family
- Total Health Care Inc
Locations
1111 Washington Blvd
Baltimore, MD 21230
Phone (410) 783-1859
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Federally Qualified Health Center (FQHC) | 261QF0400X | Yes |
Addresses
Primary practice location
2400 Kirk Ave
Baltimore, MD 21218-5507
Mailing address
1501 Division St
Baltimore, MD 21217-3121
Phone (410) 383-8300
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 905611400 | Medicaid | MD |
Other names
- Kirk Health Center
Other providers in Baltimore, MD
- Total Health Care Inc
- Total Health Care Inc
- Total Health Care Inc
- Total Health Care Inc
- Total Health Care Inc
- Total Health Care Inc
- Total Health Care Inc
- Total Health Care Inc
- Total Health Care Inc
- Total Health Care Inc
All providers in Baltimore, MD · Federally Qualified Health Center (FQHC) in Maryland
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 17, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.