NPIMap

Organization Active NPI

Luminis Health Medical Group, LLC

  • Registered Dietitian
  • Largo, MD
National Provider Identifier
1831640465
Registry record updated May 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
D02332 Issued in MD
Legal business name
LUMINIS HEALTH MEDICAL GROUP, LLC
Practice address
1450 Mercantile LN
Suite 111
Largo, MD 20774-5376
Phone
(301) 925-7610
Fax
(301) 925-7619
NPI assigned
Oct 19, 2016
Organization subpart
No

National Provider Directory

National Provider Directory
Tax ID family
Anne Arundel Phys Group LLC221 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

2003 Medical Pkwy
Ste 690
Annapolis, MD 21401

NPPES NPI Registry

Updated by the provider on May 24, 2021

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

Authorized official

Name
Peter Odenwald
Title
Vice President
Phone
(443) 481-6415

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered DietitianGroup: 193400000X SINGLE SPECIALTY GROUP 133V00000X D02332 MD Primary

Addresses

Primary practice location

1450 Mercantile LN
Suite 111
Largo, MD 20774-5376

Mailing address

PO Box 12622
Belfast, ME 04915-4017
Phone (443) 481-6476

Other names 1

  • AAMG Diabetes & Endocrine Specialists Doing business as

NPI Registry JSON

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

{
    "created_epoch": "1476835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621814400000",
    "number": "1831640465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12622",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "049154017",
            "telephone_number": "443-481-6476",
            "fax_number": "443-481-6515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1450 MERCANTILE LN",
            "address_2": "SUITE 111",
            "city": "LARGO",
            "state": "MD",
            "postal_code": "207745376",
            "telephone_number": "301-925-7610",
            "fax_number": "301-925-7619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUMINIS HEALTH MEDICAL GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-19",
        "last_updated": "2021-05-24",
        "certification_date": "2021-05-24",
        "status": "A",
        "authorized_official_last_name": "ODENWALD",
        "authorized_official_first_name": "PETER",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "443-481-6415"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": "MD",
            "license": "D02332",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "AAMG Diabetes & Endocrine Specialists",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "AAMG Diabetes & Endocrine Specialists",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Largo, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 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.