Grassroots Healing

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

GRASSROOTS HEALING

Practice address

10105 Baltimore Ave Apt 3401
College Park, MD 20740-4231

Phone

(410) 937-1766

NPI assigned

Jul 31, 2023

Organization subpart

No

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

Authorized official

Name

Melissa Jackson

Title

Owner

Phone

(301) 276-4334

Specialties & licenses 1

Addresses

Practitioners 1

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

• Olga Marie Hall, FNP-BC

  • Family Nurse Practitioner
  • Lanham, MD
  • NPI 1528621166
  NPD

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

{
    "created_epoch": "1690761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690761600000",
    "number": "1902587124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10105 BALTIMORE AVE APT 3401",
            "city": "COLLEGE PARK",
            "state": "MD",
            "postal_code": "207404231",
            "telephone_number": "410-937-1766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10105 BALTIMORE AVE APT 3401",
            "city": "COLLEGE PARK",
            "state": "MD",
            "postal_code": "207404231",
            "telephone_number": "410-937-1766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRASSROOTS HEALING",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-31",
        "last_updated": "2023-07-31",
        "certification_date": "2023-07-30",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "301-276-4334"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Nurse Practitioner in College Park, MD
• Providers in College Park, MD by specialty
• Family Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2023; 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.