NPIMap

Organization Active NPI

Lifestream Health Center

  • Non-Pharmacy Dispensing Site
  • Bowie, MD
National Provider Identifier
1841674777
Registry record updated Jun 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-Pharmacy Dispensing SiteTaxonomy code 332900000X
Legal business name
LIFESTREAM HEALTH CENTER
Practice address
4000 Mitchellville Rd
B322
Bowie, MD 20716-3104
Phone
(301) 860-0305
Fax
(301) 860-0307
NPI assigned
Jul 9, 2015
Reactivated
Jun 11, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2020

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

Authorized official

Name
Dr. Sarah Ann Merritt, MD
Title
Medical Director
Phone
(301) 860-0305

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-Pharmacy Dispensing Site 332900000X Primary

Addresses

Primary practice location

4000 Mitchellville Rd
B322
Bowie, MD 20716-3104

Mailing address

4000 Mitchellville Rd
B322
Bowie, MD 20716-3104
Phone (301) 860-0305

National Provider Directory

National Provider Directory
Tax ID family
Lifestream Health Center6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

NPI Registry JSON

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

{
    "created_epoch": "1436400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1591833600000",
    "number": "1841674777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 MITCHELLVILLE RD",
            "address_2": "B322",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207163104",
            "telephone_number": "301-860-0305",
            "fax_number": "301-860-0307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 MITCHELLVILLE RD",
            "address_2": "B322",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207163104",
            "telephone_number": "301-860-0305",
            "fax_number": "301-860-0307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFESTREAM HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-09",
        "last_updated": "2020-06-11",
        "certification_date": "2020-06-11",
        "deactivation_date": "2020-06-04",
        "reactivation_date": "2020-06-11",
        "status": "A",
        "authorized_official_last_name": "MERRITT",
        "authorized_official_first_name": "SARAH",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "301-860-0305",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bowie, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2020; 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.