NPIMap

Organization Active NPI

Sheppard Pratt Health System, Inc.

Doing business as Forbush School at Glyndon

  • Adolescent and Children Mental Health Clinic/Center
  • Reisterstown, MD
National Provider Identifier
1811041163
Registry record updated Aug 10, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X
License
03-64551 Issued in MD
Legal business name
SHEPPARD PRATT HEALTH SYSTEM, INC.
Doing business as
Forbush School at Glyndon
Practice address
407 Central Ave
Reisterstown, MD 21136-1854
Phone
(410) 517-5400
Fax
(410) 517-5600
NPI assigned
Jan 23, 2007
Last updated
Aug 10, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2009

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

Authorized official

Name
Ms. Bonnie B Katz
Title
VP Corporate Business Development
Phone
(410) 938-3150

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adolescent and Children Mental Health Clinic/Center 261QM0855X 03-64551 MD Primary

Addresses

Primary practice location

407 Central Ave
Reisterstown, MD 21136-1854

Mailing address

6501 N Charles St
Baltimore, MD 21204-6819
Phone (410) 938-3150

Other identifiers 1

IdentifierTypeStateIssuer
681500600MedicaidMD

Other names 1

  • Forbush School at Glyndon Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Sheppard Pratt Health System Inc26 organizations share this tax ID, including this one

Other organizations with this tax ID 25

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

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1249862400000",
    "number": "1811041163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6501 N CHARLES ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212046819",
            "telephone_number": "410-938-3150",
            "fax_number": "410-938-3159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 CENTRAL AVE",
            "city": "REISTERSTOWN",
            "state": "MD",
            "postal_code": "211361854",
            "telephone_number": "410-517-5400",
            "fax_number": "410-517-5600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHEPPARD PRATT HEALTH SYSTEM, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-23",
        "last_updated": "2009-08-10",
        "status": "A",
        "authorized_official_last_name": "KATZ",
        "authorized_official_first_name": "BONNIE",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "VP CORPORATE BUSINESS DEVELOPMENT",
        "authorized_official_telephone_number": "410-938-3150",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "MD",
            "license": "03-64551",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "681500600",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Forbush School at Glyndon",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Reisterstown, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2009; 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.