Impact Diagnostic Lab & Health Services

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

Legal business name

IMPACT DIAGNOSTIC LAB & HEALTH SERVICES

Practice address

7375 Executive PL Ste 222
Lanham, MD 20706-2278

Phone

(215) 252-6748

NPI assigned

Jun 13, 2022

Organization subpart

No

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

Authorized official

Name

Elizabeth A Akinfiresoye

Title

Owner/Administrator

Phone

(215) 252-6748

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in DC

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Elvira Leinyuy Nguelewou, FNP/ACNP

  • Acute Care Nurse Practitioner
  • Windsor Mill, MD
  • NPI 1780350033

  DC

  Medicare reassignment NPD

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

{
    "created_epoch": "1655078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1655078400000",
    "number": "1821728031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8551 RITCHBORO RD",
            "city": "DISTRICT HEIGHTS",
            "state": "MD",
            "postal_code": "207472646",
            "telephone_number": "215-252-6748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7375 EXECUTIVE PL STE 222",
            "city": "LANHAM",
            "state": "MD",
            "postal_code": "207062278",
            "telephone_number": "215-252-6748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMPACT DIAGNOSTIC LAB & HEALTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-13",
        "last_updated": "2022-06-13",
        "certification_date": "2022-06-13",
        "status": "A",
        "authorized_official_last_name": "AKINFIRESOYE",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER/ADMINISTRATOR",
        "authorized_official_telephone_number": "215-252-6748"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "admin@impacthomecarellc.com",
            "affiliation": "N",
            "endpointDescription": "Company Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "7375 Executive Pl Ste 222",
            "city": "Lanham",
            "state": "MD",
            "country_code": "US",
            "postal_code": "207062278",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Imind Health LLC
• Imind Integration Health LLC
• Imind Integration Health LLC
• Immaculate Supported Services, LLC
• Impact Counseling, LLC
• Impact Support Services
• Impact Support Services, Inc.
• Impeccable Healthcare Services LLC
• In Good Hands Health & Wellness, LLC
• In Heart Home Care LLC

• Health Service Clinic/Center in Lanham, MD
• Providers in Lanham, MD by specialty
• Health Service Clinic/Center in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2022; 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.