Island Connection Health Services, LLC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

Legal business name

ISLAND CONNECTION HEALTH SERVICES, LLC

Practice address

19177 Warrior Brook Dr
Germantown, MD 20874-1470

Phone

(301) 922-3527

NPI assigned

Feb 26, 2021

Organization subpart

No

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

Authorized official

Name

Mr. Patrick M Harris

Title

Owner

Phone

(301) 528-6187

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1614297600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616371200000",
    "number": "1851985139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19177 WARRIOR BROOK DR",
            "city": "GERMANTOWN",
            "state": "MD",
            "postal_code": "208741470",
            "telephone_number": "301-922-3527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19177 WARRIOR BROOK DR",
            "city": "GERMANTOWN",
            "state": "MD",
            "postal_code": "208741470",
            "telephone_number": "301-922-3527"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ISLAND CONNECTION HEALTH SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-26",
        "last_updated": "2021-03-22",
        "certification_date": "2021-03-22",
        "status": "A",
        "authorized_official_last_name": "HARRIS",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "301-528-6187",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 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.