NPIMap

Organization Active NPI

Supplemental Health

Doing business as Levindale

  • Skilled Nursing Facility
  • Idlewylde, MD
National Provider Identifier
1881063154
Registry record updated Sep 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
05863 Issued in MD
Legal business name
SUPPLEMENTAL HEALTH
Doing business as
Levindale
Practice address
1292 Limit Ave
Idlewylde, MD 21239-1747
Phone
(443) 801-5816
Fax
(866) 566-5311
NPI assigned
Sep 17, 2015
Last updated
Sep 17, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2015

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

Authorized official

Name
Ms. Linda Pate
Title
Occupaitonal Therapist
Phone
(410) 801-5816

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 05863 MD Primary

Addresses

Primary practice location

1292 Limit Ave
Idlewylde, MD 21239-1747

Mailing address

9891 Columbia Lane Pkwy
Columbia, DC 21046
Phone (301) 362-0114

Other names 1

  • Levindale Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Indian Health Services4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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": "1442448000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1442448000000",
    "number": "1881063154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9891 COLUMBIA LANE PKWY",
            "city": "COLUMBIA",
            "state": "DC",
            "postal_code": "21046",
            "telephone_number": "301-362-0114",
            "fax_number": "866-566-5311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1292 LIMIT AVE",
            "city": "IDLEWYLDE",
            "state": "MD",
            "postal_code": "212391747",
            "telephone_number": "443-801-5816",
            "fax_number": "866-566-5311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUPPLEMENTAL HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-17",
        "last_updated": "2015-09-17",
        "status": "A",
        "authorized_official_last_name": "PATE",
        "authorized_official_first_name": "LINDA",
        "authorized_official_title_or_position": "OCCUPAITONAL THERAPIST",
        "authorized_official_telephone_number": "410-801-5816",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MD",
            "license": "05863",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Levindale",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Idlewylde, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2015; 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.